PubMed · 15779201
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Matilda MacAttram. 2005. Will it deliver?. https://pubmed.ncbi.nlm.nih.gov/15779201/
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BACKGROUND: The accuracy of ethnicity information in the New Zealand hospital data was reported on in 1994. Data collected in the Barriers to Diabetes Care in the Waikato Study enables further evaluation of the accuracy of ethnicity information in hospital records. AIMS: One aim of public health policy is addressing health disparities between ethnic groups. Monitoring disparities depends on accurate outcome data, such as that from hospitals. It would be expected that this data would improve over time. This paper reports on the contemporary accuracy of ethnicity data in hospital records in the Waikato district. METHODS: Self-identified ethnicity data were gathered as part of the Barriers to Diabetes Care in the Waikato mail survey. Hospital record data were collected for those participants who had consented for access to their hospital records. RESULTS: Complete data was available for 3500 people with diabetes. Ethnicity in the hospital record was correct for one of the sometimes multiple, self-identified ethnicities for 97.7 (95CI 96.8-98.3)% of respondents. Ethnicity data were concordant for 71 (67-75)% of Maori and 99 (99-100)% of non-Maori. The non-Maori ethnic group was disaggregated into component groups: the hospital record agreed with self identified ethnicity for 89 (87-91)% of Europeans, 67 (55-78)% of Pacific groups, 70 (57-81)% of South Asian groups, 64 (48-77)% of Asian groups, and 41 (27-57)% of 'Other' ethnic groups. CONCLUSIONS: Hospital records continue to mis-record ethnicity when compared to a self-identified ethnicity. Mis-recording occurs for all ethnic groups, and is more pronounced at more specific levels of ethnic group. Researchers, clinicians, and policy makers must be cognisant of these continuing discrepancies when using hospital record data to describe ethnic variations in health status, service utilisation, or for policy planning activities.
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A re-audit was conducted at St. Mary's Sexual Assault Referral Centre to assess recording of clients' ethnicity, area of residence and assault type following training that drew on results of an initial audit. This also reassesses the ethnic and local community representation of clients in the light of more recent census data for Greater Manchester. Performances of recording ethnicity, area of residence, and assault type relevant to all new clients in 2003 (n=805) were measured against standards. Figures relating to local and ethnic populations were also compared to 2001 census data as a guide. Recording clients' ethnicity improved considerably, but recording area of residence slipped just below standard, and recording assault type dropped markedly. Overall ethnic minority representation was above general population figures, but differences existed within communities. Manchester city resident clients were over-represented compared to other county boroughs. Numbers of all clients seen at the centre had increased sharply since the original audit. Staff training following the original audit appeared to improve recording of ethnicity, whilst the heavy drop in assault type was largely attributed to an increase of referrals where the clients were not fully unconscious during the assault. The high number of Black and dual-heritage clients accounted for the 'over-representation' of ethnic minorities, masking under-representation of other ethnic communities, especially Asians. The 'over-representation' of Manchester city residents was seen to persist.