A new method for estimating race/ethnicity and associated disparities where administrative records lack self-reported race/ethnicity

被引:139
作者
Elliott, Marc N. [1 ]
Fremont, Allen [1 ]
Morrison, Peter A. [2 ]
Pantoja, Philip [1 ]
Lurie, Nicole [3 ]
机构
[1] RAND Corp, Santa Monica, CA 90407 USA
[2] RAND Corp, Nantucket, MA USA
[3] RAND Corp, Arlington, VA USA
基金
美国医疗保健研究与质量局;
关键词
Bayes's theorem; health disparities; health plans; race; surname;
D O I
10.1111/j.1475-6773.2008.00854.x
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Objective. To efficiently estimate race/ethnicity using administrative records to facilitate health care organizations' efforts to address disparities when self-reported race/ethnicity data are unavailable. Data Source. Surname, geocoded residential address, and self-reported race/ethnicity from 1,973,362 enrollees of a national health plan. Study Design. We compare the accuracy of a Bayesian approach to combining surname and geocoded information to estimate race/ethnicity to two other indirect methods: a non-Bayesian method that combines surname and geocoded information and geocoded information alone. We assess accuracy with respect to estimating (1) individual race/ethnicity and (2) overall racial/ethnic prevalence in a population. Principal Findings. The Bayesian approach was 74 percent more efficient than geocoding alone in estimating individual race/ethnicity and 56 percent more efficient in estimating the prevalence of racial/ethnic groups, outperforming the non-Bayesian hybrid on both measures. The non-Bayesian hybrid was more efficient than geocoding alone in estimating individual race/ethnicity but less efficient with respect to prevalence (p <.05 for all differences). Conclusions. The Bayesian Surname and Geocoding (BSG) method presented here efficiently integrates administrative data, substantially improving upon what is possible with a single source or from other hybrid methods; it offers a powerful tool that can help health care organizations address disparities until self-reported race/ethnicity data are available.
引用
收藏
页码:1722 / 1736
页数:15
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