Measurement challenges in developing the national healthcare quality report and the national healthcare disparities report.
OBJECTIVE
The objective of this study was to describe 2 measurement challenges faced in the development of the National Healthcare Quality Report (NHQR) and the National Healthcare Disparities Report (NHDR): the use of federal data on race and ethnicity and the selection of measures of socioeconomic status (SES).


METHODS
Over 30 federal and nonfederal data systems were examined to identify measures of race, ethnicity, and SES and to evaluate the characteristics and relative quality of the data.


RESULTS
The availability and quality of data on race, ethnicity, and SES vary by factors such as the type of data (population or establishment based-survey, administrative/claims data, or vital statistics), the source of information (self, proxy, other, or some combination), and the transition to new federal standards. No single measure of SES could be identified, so a mix of measures is presented, including income, education, and expected source of payment (ESOP). Income relative to federal poverty level was used as the preferred SES measure from person-based surveys. Selected analyses linking hospital discharge data to annual median household income from US census data were presented for data derived from administrative data systems. Educational attainment was the variable used for examining SES using data from the Vital Statistics System.


CONCLUSIONS
The first NHQR and NHDR maximized the presentation of data by accommodating the variation among data systems while at the same time imposing some standardization in the coding and classification of data on race, ethnicity, and SES.
Arispe
Irma E
IE
National Center for Health Statistics, Centers for Disease Control and Prevention, US Department of Health and Human Services, Hyattssville, MD 20782, USA. Iaa9@cdc.gov
Holmes
Julia S
JS
Moy
Ernest
E
D000368:Aged; D000847:Annual Reports as Topic; D003625:Data Collection; D004493:Education; D005006:Ethnicity; D006801:Humans; D007182:Income; D008484:Medicaid; D006278:Medicare; D019984:Quality Indicators, Health Care; D011787:Quality of Health Care; D044469:Racial Groups; D012959:Socioeconomic Factors; D014481:United States; D016270:United States Agency for Healthcare Research and Quality; D014798:Vital Statistics