Connecticut does not have statewide standards for how its medical facilities collect, report and use patient data on race, ethnicity and language – an important step towards fairness in health care, according to a new report commissioned by the Connecticut Health Foundation.
Advocates have warned that collecting data on race, ethnicity and language alone would not resolve health disparities, but by gathering and analyzing information, providers can target gaps in health outcomes. care of people of color.
“We can’t deal with what we don’t measure,” said Tiffany Donelson, president and CEO of the Connecticut Health Foundation. “Have reliable and self-reported information [race, ethnicity and language] data is essential for identifying problems and developing interventions that can benefit everyone. We know from other states that OER data can lead to better care and reduce inequalities, and we look forward to working with healthcare providers, advocates, state agencies, and patients to advance these outcomes. things in Connecticut. “
For years, advocates have pushed for better data collection. Although many health systems in Connecticut collect some of this data, the level varies and fewer organizations are using the information to process care, the Health Foundation noted in its report.
Most of the race-related statistics collected in the state – from Medicaid enrollment to the uninsured population – show the health outcomes for black, Hispanic, Asian and white residents. These broader categorizations mask disparities that affect residents of certain races and ethnicities. For example, diseases that disproportionately affect Puerto Ricans or Mexicans may not fit into the data that more broadly covers Hispanics.
“While public health data clearly documents the worst health outcomes for people of color, most health systems and other health care providers do not routinely track data on race, ethnicity or language preference. (REL) self-reported patients to find inequalities or intervene when there is a change. could make the difference ”, the authors written in the Foundation’s report for health. “The lack of standardized data can be especially difficult for ethnic or racial groups with smaller populations, including Asian Americans and Native Americans, whose population-level outcomes are often not even reported in public health data. “
Last month, the General Assembly gave final passage to a bill that, among other things, requires better collection of data on race, ethnicity and language among agencies, boards and commissions. the state. These groups must now gather information in a way that allows aggregation and disaggregation; provides the ability to select one or more ethnic or racial designations and include an “other” designation with the ability to write in unrepresented identities; and ensure that, in cases where data concerning a person’s race or ethnicity is reported to another public body, such data is not compiled or disclosed without race and origin information ethnic. The bill sets out several other mandates for data collection.
What can be done?
As Connecticut braces for changes in the way it collects data, the Health Foundation willing overview to improve collection, analysis and use, drawing on examples from other states.
Here are some examples in other health systems:
- In Minnesota, analysis of REL data by HealthPartners found a 12.3% difference in colorectal cancer screening between white patients and patients of color. After pledging to close the gap, the health care system narrowed the gap to 7.1% in four months.
- Analysis of REL data by the same company found a significant disparity in mammogram rates between white and black women. After finding that offering same-day screening would help encourage black women to have mammograms, the healthcare system narrowed the screening gap from 16% to 2%.
- In Massachusetts, the Brigham and Women’s Hospital analyzed 10 years of REL data and found that black and Latin patients with heart failure were less likely to be admitted to cardiology for heart failure care than white patients. – which could help explain the racial inequalities in the heart. failure results. The hospital is currently developing interventions to address this injustice.
The report also looked at some of Connecticut’s health systems. Hartford HealthCare plans to use data on race, ethnicity and language to assess readmissions and patient experiences. The system has recently added more granular fields and trains staff to answer patient questions. At Yale New Haven Health, data collection takes place but is inconsistent and in some cases the accuracy is unclear, the report says. The health system is starting to collect OER data in some clinics, including one focused on hypertension.
To ensure better collection and use of data in the future, the Foundation for Health advised that health care providers and public bodies:
- Make key decisions on how the data will be collected and who will be responsible for collecting it before the initiative begins.
- Examine the infrastructure to make sure that healthcare systems have what they need to record and store OER data, and that they are adhering to privacy guidelines.
- Train staff in OER data collection. Ensure workers are properly trained and able to articulate the purpose of data collection and answer patient questions.
- Make sure the data is collected and verified for accuracy and completeness.
- Once collected, examine the data and identify inequities; prioritize specific areas and change systems to eliminate health inequalities and improve care through clinical interventions.
- To address health inequalities on a larger scale, OER data collection will need to be implemented across state health systems in a coordinated manner.
For state agencies, boards and commissions, improved data collection is due to begin by January 1, 2022.
Editor’s Note: The CT Mirror is a Connecticut Health Foundation grantee.