title: Responses of Massachusetts hospitals to a state mandate to collect race, ethnicity and language data from patients: a qualitative study.
abstract: BACKGROUND
  A Massachusetts regulation implemented in 2007 has required all acute care hospitals to report patients' race, ethnicity and preferred language using standardized methodology based on self-reported information from patients. This study assessed implementation of the regulation and its impact on the use of race and ethnicity data in performance monitoring and quality improvement within hospitals.
  
  
  METHODS
  Thematic analysis of semi-structured interviews with executives from a representative sample of 28 Massachusetts hospitals in 2009.
  
  
  RESULTS
  The number of hospitals using race, ethnicity and language data internally beyond refining interpreter services increased substantially from 11 to 21 after the regulation. Thirteen of these hospitals were utilizing patient race and ethnicity data to identify disparities in quality performance measures for a variety of clinical processes and outcomes, while 16 had developed patient services and community outreach programs based on findings from these data. Commonly reported barriers to data utilization include small numbers within categories, insufficient resources, information system requirements, and lack of direction from the state.
  
  
  CONCLUSIONS
  The responses of Massachusetts hospitals to this new state regulation indicate that requiring the collection of race, ethnicity and language data can be an effective method to promote performance monitoring and quality improvement, thereby setting the stage for federal standards and incentive programs to eliminate racial and ethnic disparities in the quality of health care.
authors.affiliation: Department of Health Care Policy, Harvard Medical School, Boston, MA, USA. ayanian@hcp.med.harvard.edu
authors.forename: Selena
authors.initials: S
authors.lastname: Jorgensen
authors.forename: Ruth
authors.initials: R
authors.lastname: Thorlby
authors.forename: Robin M
authors.initials: RM
authors.lastname: Weinick
authors.forename: John Z
authors.initials: JZ
authors.lastname: Ayanian
mesh_terms: D016542:Chief Executive Officers, Hospital / Q000523:psychology* / Q000706:statistics & numerical data; D015331:Cohort Studies; D003625:Data Collection / Q000592:standards* / Q000706:statistics & numerical data; D005006:Ethnicity / Q000523:psychology / Q000706:statistics & numerical data*; D005260:Female; D006306:Health Surveys; D054625:Healthcare Disparities / Q000706:statistics & numerical data*; D006742:Hospital Bed Capacity / Q000706:statistics & numerical data; D006755:Hospital Shared Services; D015285:Hospital-Patient Relations; D006801:Humans; D007396:Internship and Residency; D007802:Language; D008297:Male; D037141:Mandatory Programs / Q000592:standards*; D008404:Massachusetts; D010043:Outcome and Process Assessment, Health Care / Q000592:standards*; D036301:Qualitative Research; D044469:Racial Groups; D020444:Reimbursement, Disproportionate Share; D013219:State Government; D011795:Surveys and Questionnaires