title: Enhancing Clinical Content and Race/Ethnicity Data in Statewide Hospital Administrative Databases: Obstacles Encountered, Strategies Adopted, and Lessons Learned.
abstract: OBJECTIVE
  Eight grant teams used Agency for Healthcare Research and Quality infrastructure development research grants to enhance the clinical content of and improve race/ethnicity identifiers in statewide all-payer hospital administrative databases.
  
  
  RESULTS
  Grantees faced common challenges, including recruiting data partners and ensuring their continued effective participation, acquiring and validating the accuracy and utility of new data elements, and linking data from multiple sources to create internally consistent enhanced administrative databases. Successful strategies to overcome these challenges included aggressively engaging with providers of critical sources of data, emphasizing potential benefits to participants, revising requirements to lessen burdens associated with participation, maintaining continuous communication with participants, being flexible when responding to participants' difficulties in meeting program requirements, and paying scrupulous attention to preparing data specifications and creating and implementing protocols for data auditing, validation, cleaning, editing, and linking. In addition to common challenges, grantees also had to contend with unique challenges from local environmental factors that shaped the strategies they adopted.
  
  
  CONCLUSIONS
  The creation of enhanced administrative databases to support comparative effectiveness research is difficult, particularly in the face of numerous challenges with recruiting data partners such as competing demands on information technology resources. Excellent communication, flexibility, and attention to detail are essential ingredients in accomplishing this task. Additional research is needed to develop strategies for maintaining these databases when initial funding is exhausted.
authors.affiliation: Michael Pine and Associates, 1 East Upper Wacker Drive #1210, Chicago, IL.
authors.forename: Michael
authors.initials: M
authors.lastname: Pine
authors.affiliation: Social & Scientific Systems, Inc., Silver Spring, MD.
authors.forename: Niranjana M
authors.initials: NM
authors.lastname: Kowlessar
authors.affiliation: Baylor College of Medicine, 3701 Kirby Drive, Room LMPL-600, Mail Stop BCM700, Houston, TX, 77098.
authors.forename: Jason L
authors.initials: JL
authors.lastname: Salemi
authors.affiliation: Hawaii Health Information Corporation, Honolulu, HI.
authors.forename: Jill
authors.initials: J
authors.lastname: Miyamura
authors.affiliation: UCLA Division of General Internal Medicine and Health Services Research, Los Angeles, CA.
authors.forename: David S
authors.initials: DS
authors.lastname: Zingmond
authors.affiliation: University of New Mexico, Albuquerque, NM.
authors.forename: Nicole E
authors.initials: NE
authors.lastname: Katz
authors.affiliation: Minnesota Hospital Association, St. Paul, MN.
authors.forename: Joe
authors.initials: J
authors.lastname: Schindler
mesh_terms: D003625:Data Collection / Q000379:methods*; D016208:Databases, Factual; D005006:Ethnicity / Q000706:statistics & numerical data*; D006302:Health Services Research / Q000458:organization & administration*; D006801:Humans; D010351:Patient Discharge; D058996:Quality Improvement; D044469:Racial Groups / Q000706:statistics & numerical data*; D012109:Research Support as Topic; D014481:United States; D016270:United States Agency for Healthcare Research and Quality
keywords: Hospital administrative data; data enhancement; information technology in health