2012 VIReC Database and Met

2012 VIReC Database and Met

Cyber Seminar Series

RESEARCHERS’ GUIDE TO VA DATA RESEARCHERS’ GUIDE TO VA DATA 
2012 VIReC Database and Methods Cyber Semina

Assessing Race and Ethnici

May 7, 2012

Presented by: Maria Mor, PhD

Center for Health Equity Research and Promot

VA Pittsburgh Healthcare System

RESEARCHERS’ GUIDE TO VA DATA RESEARCHERS’ GUIDE TO VA DATA 
Session Objectives

Introduction/Overview Race and Ethnicity in the VA Data Race and Ethnicity in Medicare Data Race and Ethnicity in Medicare Data Quality of VA Race/Ethnicity Data Recommend ti a ons 

Where to Go for More Help 

RESEARCHERS’ GUIDE TO VA DATA RESEARCHERS’ GUIDE TO VA DATA 
Session Objectives

Introduction/Overview Race and Ethnicity in the VA Data Race and Ethnicity in Medicare Data Race and Ethnicity in Medicare Data Quality of VA Race/Ethnicity Data Recommend ti a ons 

Where to Go for More Help 

RESEARCHERS’ GUIDE TO VA DATA RESEARCHERS’ GUIDE TO VA DATA 
Introduction/Overview

Racial/ethnic disparities in health and health Racial/ethnic disparities in health and health well-documented and persistent in the US – Root causes and solutions are not well underst– While quality is improving (in general), access 

are not improving (AHRQ 2010) 

Racial/ethnic disparities also exist in VHA, whbarriers to receiving care are minimized – Potential contributors include patient factors p

Potential contributors include patient factors, pdecision-making, and VAMC characteristics (Sa

More research to detect understand and adMore research to detect, understand, and addisparities in health and health care is neede

RESEARCHERS’ GUIDE TO VA DATA RESEARCHERS’ GUIDE TO VA DATA 
Introduction/Overview

Accurate race/ethnicity data are essentiadisparities research and research on clinidisparities research and research on cliniassociated with race Problems with race/ethnicity data in the V— Completeness — Accuracy Accuracy — Consistency over time 

RESEARCHERS’ GUIDE TO VA DATA RESEARCHERS’ GUIDE TO VA DATA 
t

Session Objectives

Introduction/Overview Race and Ethnicity ii n thth e VA Data VA D Race and Ethnicity in Medicare Data VA Race Data Quality Recommendations Recommendations Where to Go for More Help 

RESEARCHERS’ GUIDE TO VA DATA RESEARCHERS’ GUIDE TO VA DATA 
t

VA Race and Ethnicity Categor

VHA Handbook VHA Handbook 1601A 01 . (200

Ethnicity— Spanish, Hispanic, or Latino Race (>1 may be selected) Race (>1 may be selected) — American Indian or Alaska Native — Asian — Black or African American — Native Hawaiian or Other Pacific Islander — White — Unknown by Patient C ti th d Current reporting method — 2 question format: ethnicity, race — Self -reported reported 

RESEARCHERS’ GU RESEARCHERS IDE TO VA DATA ’ GUIDE TO VA DATA 
Race and Ethnicity Data Collection St

OMB Directive Revision No. 15 (1997) 

— Standards for maintaining, collecting, and 

federal data on race and ethnicity 

— Implemented in DVA in 2003 

Joint Commission (2010) 

— Collection of patient demographic data, e.

ethnicity key element of performance ethnicity key element of performance 

Affordable Care Act currently under revie

— New data collection standards for race et

New data collection standards for race, et

primary language, and sex 

RESEARCHERS’ GUIDE TO VA DATA RESEARCHERS’ GUIDE TO VA DATA 
VHA Health Equality Workgrou

Chartered by Dr. Jesse in 2011 

– Advise leadership: how to coordinate VHA 

to achieve equity in Veteran health care to achieve equity in Veteran health care 

VHA accepts recommendations aligned wdimensions of National Partnership for Acdimensions of National Partnership for AcEliminate Health Disparities: – leadership – awareness – health and health care outcomes – diversity and cultural compe

tence 

of the workforce

d 

f th 

– data, research, and evaluation 

RESEARCHERS’ GUIDE TO VA DATA RESEARCHERS’ GUIDE TO VA DATA 
Workgroup Recommendations Rela

Data Research and EvaluatioData, Research, and Evaluatio

Universal stan

dar

d collection o

f self-reported

race/ ethnicity, primary language, rural/urba

and sex and sex Identify unrecognized and emerging vulnerapopulations Assess/report differences stratified by vulner

— Quality of care — Patient satisfaction — Access to care 

Harmonize standards for vulnerable populatioHarmonize standards for vulnerable populatioand Affordable Care Act data standards 

RESEARCHERS’ GUIDE TO VA DATA RESEARCHERS’ GUIDE TO VA DATA 
t t

Acquisition of Race/Ethnicity Data 

WHO: 

If i n ormation 

Source: • Patient 

(self -report) 

• Proxy 

WHAT: 

• VA Form 10-

10EZ, Application 

for Health for Health Benefits (online, paper, or by i t i ) interview) 

WHEN: 

• E ll nro ment • Hospital 

admission 

• Outpatient Outpatient 

visit or preregistration 

WHERE: 

• O li n ne 

• Telephone 

call from 

local VHA local VHA facility 

• In-person 

visit to local VHA facility 

• V

V

EC

ddAInES S

• O

p

• C

Cine

RESEARCHERS’ GUIDE TO VA DATA RESEARCHERS’ GUIDE TO VA DATA 
Race/Ethnicity Data Collection: His

Method of ascertainment uncertain, primobserver-re

ported 

No option for multiple race reporting 

Single question captured both race and e– Hispanic, White – Hispanic, Black Hispanic, Black – American Indian – Black – Asian – White 

RESEARCHERS’ GUIDE TO VA DATA RESEARCHERS’ GUIDE TO VA DATA 
Race/Ethnicity Data Collection: Enro

VA Form 10-10EZ (Application for Health Data entered into the Veterans Health InS t d T h l A hit t ( Sys

tems and Tec

hnology Architec

ture (Vi 

— Race Information and Patient Information Sub

Demographic data (e g race) transmitteDemographic data (e.g., race) transmitteencounter data to the Austin Information Center 

— National Patient Care Database 

Medical SAS 

(MedSAS

) datasets 

— Extracts of NPCD data 

RESEARCHERS’ GUIDE TO VA DATA RESEARCHERS’ GUIDE TO VA DATA 
Race/Ethnicity Data Collection: Clinica

Race and ethnicity obtained during pre-reif missing Race and ethnicity gathered directly from (or proxy) 

— Hospital admission — Clinic registration

Data entered into Data entered into VistA

— Race Information and Patient Information Sub

Separate VistA field for method of data cSeparate VistA field for method of data c

RESEARCHERS’ GUIDE TO VA DATA RESEARCHERS’ GUIDE TO VA DATA 
Sources of Race Data in the V

Medical SAS Datasets

Variable Name MedSAS Dataset Description RACE Inpatient (PTF Main File) FY1970 - prese

Outpatient (Visit File) FY1997 - preseOutpatient (Event File) FY1998 - prese

RACE1-RACE6 Inpatient (PTF Main) FY2003 - preseRACE1-RACE7 Outpatient (Visit, Event) FY2004 - preseETHNIC Inpatient (PTF Main) FY2003 - prese

Outpatient (Visit, Event) FY2004 - prese

RESEARCHERS’ GUIDE TO VA DATA RESEARCHERS’ GUIDE TO VA DATA 
t

Other Sources of Race Data in th

VA Vit l St Fil VA Vital Status File – Death dates from multiple VA and non-VA data 

PTF, BIRLS , SSA, Medicare )

– Contains race data from Medicare – VSF file structure 

– Mtas er Fil t i File contains one record f h S

d for each S

birth (DOB)-gender combination found in V

– Some SSNs have more than one record. – Mini File contains one record for each SSN

is used to select the “best” DOB, gender, aeach SSN. 

– Race is in Master File only 

Decision Support System National Data E

RESEARCHERS’ GUIDE TO VA DATA RESEARCHERS’ GUIDE TO VA DATA 
Session Objectives

Introduction/Overview Race and Ethnicity in the VA Data Race and Ethnicity in Medicare Data Quality of VA Race/Ethnicity Data Recommendations ecommendations Where to Go for More Help 

RESEARCHERS’ GUIDE TO VA DATA RESEARCHERS’ GUIDE TO VA DATA 
Medicare Race/Ethnicity Dat

Potentially useful source for Veterans in M— Age 65 and older (>95% of VA elderly) — Disabled (~20% of VA patients <65 years) — End stage renal disease Derived primarily from Social Security Ad— Obtained at the time of application for SSN and

replacement card replacement card 

— Reporting sources: Usually self- or family Distinctions from current VA race/ethnicitDistinctions from current VA race/ethnicit— ‘Hispanic’ is a race category — No multiple race 

RESEARCHERS’ GUIDE TO VA DATA RESEARCHERS’ GUIDE TO VA DATA 
Medicare Race Data from SS

Until 1980, 4 categories only — White — Black — Other — U kn

known 

In 1980, ‘Other’ replaced by 

A i s an, Ai

A

sian American or

P P

— A acifi

c I

slan

d

e

r Il 

— Hispanic — American Indian or Alaskan Native

RESEARCHERS’ GUIDE TO VA DATA RESEARCHERS’ GUIDE TO VA DATA 
Medicare Race Data from SS

Medicare race data quality issues — Information on most enrollees 

(those who obta

to 1980) limited to original 4 categories 

— SSN application form – single question format 

multiple race reporting multiple race reporting 

Initiatives to improve quality of race/ethn— Periodic updates on American Indians and Alas

Periodic updates on American Indians and Alasfrom Indian Health Service 

— 1997 survey of enrollees classified as ‘Other’, ‘

with Spanish surname requesting race/ethniciwith Spanish surname, requesting race/ethnici

RESEARCHERS’ GUIDE TO VA DATA RESEARCHERS’ GUIDE TO VA DATA 
Session Objectives

Introduction/Overview Race and Ethnicity in the VA Data Race and Ethnicity in Medicare Data Quality of VA Race/Ethnicity Data Recommendations ecommendations Where to Go for More Help 

RESEARCHERS’ GUIDE TO VA DATA RESEARCHERS’ GUIDE TO VA DATA 
Quality of VA Race/Ethnicity Da

Completeness Completeness 

A substantial portion of patients do not h“usabl

e

” race value

* i h n t

he VA M

edi cal SA

l SA

and Outpatient Datasets 

FYear Usable Race % Usable Race, % FYear Usable R

Usable R

1997 57 2005 61998 57 2006 71999 58 2007 72000 58 2008 72001 56 2009 72002 55 2010 82003 49 2011 82004 62 

* A usable race value is any value that is not 

RESEARCHERS’ GU RESEARCHERS IDE TO VA DATA ’ GUIDE TO VA DATA 

A usable race value is any value that is not missing 

‘missing’ 

‘declined’ 
Use of Medicare and DoD Data for Impr

VA Race Data Quality VA Race Data Quality 

Stroupe, et al. (2010) Journal of Rehabilitation Research & 

Aims 

1. To estimate the extent missin

g “usable

in VA MedSAS files can be reduced by uVA data sources 

a. Medicare b. DoD 

2. To evaluate the agreement between VA 

reported race data in MedSAS files and

a. Medicare race data Medicare race data b. DoD race data 

RESEARCHERS’ GUIDE TO VA DATA RESEARCHERS’ GUIDE TO VA DATA 
t t

Use of Medicare and DoD Data for Impro

VA Race Data Quality

Stroupe, et al. (2010) Journal of Rehabilitation Research & 

Patient cohort Patient cohort— 10% representative sample of VHA patient

obtained services during FY2004-2005 

— N = 570,018 Medicare race data were obtained from MVital Status file DoD race data were obtained from the VAIdentity RR epository (VADIR) database for 

(VADIR) d 

f 

<65 years 

– VA/DoD data-sharing agreement sharing agreement – Self-reported race/ethnicity obtained from 

servicemembers servicemembers 

RESEARCHERS’ GU RESEARCHERS IDE TO VA DATA ’ GUIDE TO VA DATA 
, ce a a ( )

Use of Medicare and DoD Data for Impro

VA Race Data Quality

Stroupe, et al. (2010) Journal of Rehabilitation Research & 

Patients with & without Usable Ra D t VA Race Data VA MedSAS 

Usable 

Race Value 

(n=275,008) 

N

Age, >65 years, % 43 

Male,% 94 

Married, % 56 

Geographic Region, % 

Northeast 16 South 44 

Midwest 23 

West 17 

RESEARCHERS’ GUIDE TO VA DATA RESEARCHERS’ GUIDE TO VA DATA 
om 

S d S l (570 018)

(<1%)

Aim 1a: Improvement in Race Comple

with Addition of Medica e Data f 20

ith Addition of Medicare Data from 20

Yes No

Study Sample (570,018) 

Usable Race Value in MedSAS? 

Yes No

275,008 (48%) 295,010 (52%) 

Medicare Record Match? 

Yes No

157,189 (53%) 137

Usable Race Value in Medicare? 

Yes No 

155,108 (99%) 2,081 

RESEARCHERS’ GUIDE TO VA DATA RESEARCHERS’ GUIDE TO VA DATA 

(<1%) 
Aim 1a: Improvement in Race Complet

with Addition of Medicare Data from 200with Addition of Medicare Data from 200

RESEARCHERS’ GUIDE TO VA DATA RESEARCHERS’ GUIDE TO VA DATA 
o

S d S l 65 (319 756)

Aim 1b: Improvement in Race Comple

with Addition of ith Addition of DoD Data f m 2004 Data from 2004

Yes No

Study Sample < 65 years (319,756) 

Usable Race Value in MedSAS? 

Yes No

156,474 (48%) 162,882 (52%) 

DoD Record Match? 

Yes No

134,892 (83%) 27,

Usable Race Value in DOD? 

Yes No 

60,286 (45%) 74,606 (55%) 

RESEARCHERS’ GUIDE TO VA DATA RESEARCHERS’ GUIDE TO VA DATA 
Aim 1b: Improvement in Race Complet

with Addition of with Addition of DoD Data from 2004 Data from 2004 

-

RESEARCHERS’ GUIDE TO VA DATA RESEARCHERS’ GUIDE TO VA DATA 
Aim 1: Improvement in Race Complete

with Addition of Medicare and Addition of Medicare and DoD Data from 

Data from 

RESEARCHERS’ GUIDE TO VA DATA RESEARCHERS’ GUIDE TO VA DATA 
RESEARCHERS GUIDE TO VA DATA

Aim 2: Comparison of Medica

with VA d ith VA and D Do D t 2004 Data, 2004-2

VA Race Medicare Race DoD Data 

C

White White White 

Black or African 

American Black Black B

American Indian or 

Alaska Native 

North American 

Native 

American Indian or 

Alaska Native 

N

Asian Asian A i P ifi Asian or Pacific Islander 

Native Hawaiian or Is

Other Pacific 

Islander ’ 

Other Other 
-

Aim 2a: Comparison of VA with Me

Data 2004 Data, 2004 2005

RESEARCHERS’ GUIDE TO VA DATA RESEARCHERS’ GUIDE TO VA DATA 
Aim 2a: Comparison of VA with M

D t 2004 D

a

ta, 2004

-2005

Race Sensitivity Specificity 

White 98.5 91.3 

Black or African 

American 96 4. 99 3. 

North American 

Native 35 8. 99 8. 

Asian, Pacific 

Islander or Other 46.8 99.3 

RESEARCHERS’ GUIDE TO VA DATA RESEARCHERS’ GUIDE TO VA DATA 
-

Aim 2a: Comparison of VA with Me

Data 2004 Data, 2004 2005

RESEARCHERS’ GUIDE TO VA DATA RESEARCHERS’ GUIDE TO VA DATA 
-

Aim 2b: Comparison of VA with 

Data 2004 Data, 2004 2005

RESEARCHERS’ GUIDE TO VA DATA RESEARCHERS’ GUIDE TO VA DATA 
Aim 2b: Comparison of VA with 

D t 2004 D

a

ta, 2004

-2005

Race Sensitivity Specificity 

White 93.4 94.2 

Black or African 

American 95 4. 98 5. 

North American 

Native 39 2. 99.5 

Asian, Pacific 

Islander or Other 64.5 96.3 

RESEARCHERS’ GUIDE TO VA DATA RESEARCHERS’ GUIDE TO VA DATA 
y

Use of Medicare and DoD Data for Impro

VA Race Data Quality

Stroupe, et al. (2010) Journal of Rehabilitation Research & 

Conclusion 

Supplementing VA with Medicare and data improves VA race data completensubstantially substantially More study is needed to understand prates of agreement between VA and erates of agreement between VA and esources in identifying non-African-Ameminority individuals 

RESEARCHERS’ GUIDE TO VA DATA RESEARCHERS’ GUIDE TO VA DATA 
Improving Patient Demographic Inf

in VA Databases

T21

-funded collaboration between Cen

funded collaboration between Cen

Health Equity Research and Promotion Veterans En

gineeringResource Center 

Patients (n=173) with missing or declinat VA Pittsburgh Healthcare System wesurveyed by telephone regarding their: 

– Comfort with being asked to provide 

race

/

eth

nicity, 

a

dd

ddress/t

elep

hone, and

insurance when coming to the VA

– Preference for providing that informatio

Preference for providing that informatioclerk or computer kiosk 

RESEARCHERS’ GUIDE TO VA DATA RESEARCHERS’ GUIDE TO VA DATA 
Comfort in Providing Race/Ethnicit

100% 4%

Comfort in Providin

g Requested Information 

(N=173) 

60%70%80%90% 8% 5%

CoSo

L

30%40%50%60%

93%

85% 86%

NeSoCo

0%

10%20%

Address Insurance Race/Ethnicity 

Information Type 

aData values not shown fo

RESEARCHERS’ GUIDE TO VA DATA RESEARCHERS’ GUIDE TO VA DATA 
Preference for Collection of Race/Ethn

Preferred Mode for Updating Information 

100% 17% 10%

Preferred Mode for Updating Information 

(N=48) 

60%70%80%90%

100%

33% 42%17%

K

P

30%40%50%60%

46% 44%

NC

0%

10%20%

Insurance/Address Race/Ethnicity 

Information Type 

RESEARCHERS’ GUIDE TO VA DATA RESEARCHERS’ GUIDE TO VA DATA 
Session Objectives

Introduction/Overview Race and Ethnicity in the VA DataRace and Ethnicity in Medicare Data Quality of VA Race/Ethnicity DataRecommendations Where to Go for More Help 

RESEARCHERS’ GUIDE TO VA DATA RESEARCHERS’ GUIDE TO VA DATA 
d dua s t e S t e use a t 

Recommendations

When using VA VSF, match on date of birgender in addition to (scrambled) SSN gender, in addition to (scrambled) SSN 

—Researchers will be most likely to iden

in

dividuals in 

t

h

e V

SF if 

t

hey use 

all 

th

elements when conducting their VSF-srecord match 

Use of Medicare race information will redproblem of missing race in VA studies us

ad i i t ti d t d

minis

trative d

a

ta 

RESEARCHERS’ GUIDE TO VA DATA RESEARCHERS’ GUIDE TO VA DATA 
Recommendations

Use of a dichotomous race classification oBlack/African American and Other in VA sMedicare race information results in highaccurate classification than other groupin

—VA North American Natives and Hispan

frequently misclassified as White (and Hispanic) in Medicare Hispanic) in Medicare 

—Medicare White and African-American 

b

oth h

ad hi di d hi

ghpredi

ctive values

RESEARCHERS’ GUIDE TO VA DATA RESEARCHERS’ GUIDE TO VA DATA 
Recommendations

Medicare data cannot be used to identHispanics with any degree of accuracy completeness 

Consider other supplementary data so– Department of Defense 

– S

pecial surve

ys 

RESEARCHERS’ GUIDE TO VA DATA RESEARCHERS’ GUIDE TO VA DATA 
Session Objectives

Introduction/Overview Race and Ethnicity in the VA Data Race and Ethnicity in Medicare Data Race and Ethnicity in Medicare Data Quality of VA Race/Ethnicity Data Recommen

d

ations 

Where to Go for More Help 

RESEARCHERS’ GUIDE TO VA DATA RESEARCHERS’ GUIDE TO VA DATA 
t t

VIReC Help

VIReC Webpage (http://www.virec.resear– Information on VA data sources and how t

Information on VA data sources and how t

– Documentation on some VA datasets, e.g.

datasets

HSRData Listserv– Join at the VIReC Web site – Discussion among >500 data stewards, m

users

Past messages ii n archive (( – hi on i t n ranet)

VIReC Help Desk

– VIReC staff will answer your question and/

VIReC staff will answer your question and/to available resources on topics 

– VIReC@va.gov VIReC@va.gov or (708) 202

RESEARCHERS’ GUIDE TO VA RESEARCHERS’ GUIDE TO VA DATA

-2413 
-

Selected Recent References o

Race/Ethnicity Data

AHRQ (Agency for Healthcare Research and Quality) (2005). National healthcare disparities report, 2005 (Rep. No. AHRQ Publicatio

MD: U.S. Department of Health and Human Services, Agency for Healthcare Research and Quality. 

Baker DW, Cameron KA, Feinglass J, Thompson, JA, Geor gas P, Fos ter S, et al. (2006). A system for rapidly and accurately collectin

Am J Public Health, 96, 532-537. 

Bertolli J, LeeLisa M, Sullivan PS. (2007). Racial Misidentification of American Indians/Alaska Natives in the HIV/AIDS Reporting Sy

Urban Health Jurisdiction, U.S., 1984–2002. Public Health Reports, 122, 382-392. 

Blustein J. (1994). The Reliability of Racial Classifications in Hospital Discharge Abstract Data. American Journal of Public Health, 84

Boehmer U, Kressin NR, Berlowitz DR, Christiansen CL, Kazis LE, Jones JA. (2002). Self-reported vs administrative race/ethnicity da

Public Health, 92, 1471-1472. 

Brahan D, Bauchner H. (2005). Changes in reporting of race/ethnicity, socioeconomic status, gender, and age over 10 years. Pedia

Clegg LX, Reichman ME, Hankey BF, Miller BA. Lin YD, Johnson NJ, et al. (2007). Quality of race, Hispanic ethnicity, and immigrant 

cancer registry data: implications for health disparity studies. Cancer Causes Control, 18, 177-187. 

Eicheldinger C, Bonito A. (2008). More accurate racial and ethnic codes for Medicare administrative data. Health Care Financ Rev, 2

Elliott MN, Fremont A, Morrison PA, Pantoja P, Lurie N. (2008). A new method for estimating race/ethnicity and associated disparitie

records lack self-reported race/ethnicity. Health Serv Res. 

F d ME K ll PA (2005) C t li i d t i i d th i it i h lth i Ford ME, Kelly PA. (2005). Conceptualizing and categorizing race and ethnicity in health services research. H lth S R 40 Health Serv Res, 40, 16

Friedman DJ, Cohen BB, Averbach AR, Norton JM. (2000). Race/ethnicity and OMB Directive 15: implications for state public health 

90, 1714-1719. 

Gomez SL, Kelsey JL, Glaser SL, Lee MM, Sidney S. (2005). Inconsistencies between self-reported ethnicity and ethnicity recorded 

organization. Ann Epidemiol, 15, 71-79. 

Gomez SL, Glaser SL. (2006). Misclassification of race/ethnicity in a population-based cancer registry (United States). Cancer Cause

Hahn RA (1992) The state of federal health statistics on racial and ethnic groups Hahn RA. (1992). The state of federal health statistics on racial and ethnic groups. JAMA 267 JAMA, 267, 268 -271.

Hahn RA, Stroup DF. (1994). Race and ethnicity in public health surveillance: criteria for the scientific use of social categories. Publ

Hamilton NS, Edelman D, Weinberger M, Jackson GL. (2009). Concordance between self-reported race/ethnicity and that recorded 

medical record. N C Med J, 70, 296-300. 

Institute of Medicine. (2003). Unequal treatment: Confronting racial and ethnic disparities in health care Washington, DC: National Jones CP, Truman BI, Elam-Evans LD, Jones CA, Jones CY, Jiles R, et al. (2008). Using "socially assigned race" to probe white adva

Dis, 18, 496 -504. 

Kashner TM. (1998). Agreement between administrative files and written medical records: a case of the Department of Veterans Af

1336. 

Kramer BJ, Wang M, Hoang T, Harker JO, Finke B, Saliba D. (2006). Identification of American Indian and Alaska Native veterans in 

Veterans Health Administration and the Indian Health. 

Laws MB, Heckscher RA. (2002). Racial and ethnic identification practices in public health data systems in New England. Public Hea

RESEARCHERS’ GUIDE TO VA DATA RESEARCHERS’ GUIDE TO VA DATA 
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, ,

g g ( ) g p p p

Selected Recent References o

Race/Ethnicity Data

Long JA, Bamba MI, Ling B, Shea JA. (2006). Missing race/ethnicity data in Veterans Health Administration based disparities resear

Health Care Poor Underserved. 17(1):128-40. Review. 

Mays VM, Ponce NA, Was hington DL, Cochran S D. (2003). Classification of race and ethnicity: implications for public health. Annu R

McAlpine DD, Beebe TJ, Davern M, Call K T. (2007). Agreement between self-reported and administrative race and ethnicity data am

Minnesota. Health Serv Res, 42, 2373-2388. 

McBean AM. (2006). Improving Medicare's Data on Race and Ethnicity. National Academy of Social Insurance. Medicare Brief, No. 

Ref Type: Serial (Book,Monograph) 

Morgan RO, Wei II, Virnig BA. (2004). Improving identification of Hispanic males in Medicare: use of surname matching. Med Care, Office of Management and Budget Revisions to the Standards for the Classification of Federal Data on Race and Ethnicity, Notice of 

Pan CX, Glynn RJ, Mogun H, Choodnovskiy I, Avorn J. (1999). Definition of race and ethnicity in older people in Medicare and Medic

733. 

Polednak AP. (2001). Agreement in race-ethnicity coding between a hospital discharge database and another database. Ethn Dis, 1

Rhoades D. (2005). Racial Misclassification and Disparities in Cardiovascular Disease Among American Indians and Alaska Natives. 

Saha S, Freeman M, Toure J, Tippens KM, Weeks C, Ibrahim S. (2008). Racial and ethnic disparities in the VA Health Care System: 

of General Internal Medicine, 23, 654-671. 

Sohn M, Zhang H, Arnold N, Stroupe K, Taylor B, Wilt T, et al. (2006). Transition to the new race/ethnicity data collection standard

Affairs. Population Health Metrics, 4. 

Sondik EJ, Lucas JW, Madans JH, Smith, SS. (2000). Race/ethnicity and the 2000 census: implications for public health. Am.J Publi

Stehr-Green P, Bettles J, Robertson LD. (2002). Effect of racial/ethnic misclassification of American Indians and Alaska Natives on W

certificates, 1989-1997. American Journal of Public Health, 92, 443-444. 

Stroupe KT, Tarlov E, Zhang Q, Haywood T, Owens A, Hynes DM. Use of Medicare and DoD data for improving VA race data quality

Research & Development. 2010;47(8):781 2010;47(8):781 -795. 

Sugarman J, Soderberg R, Gordon J, Rivara, FP. (1993). Racial misclassification of American Indians: its effect on injury rates in Or

through 1990. Am J Public Health, 83, 681-684. 

Sugarman J, Holliday M, Oss, A, Astorina J, Hui Y. (1996). Improving American Indian cancer data in the Washington State Cancer 

using linkages with the Indian Health Service and Tribal Records. Cancer, 78, 1564-1568. 

The Joint Commission: Advancing Effective Communication, Cultural Competence, and Patient- and Family-Centered Care: A Roadm

Terrace, IL: The Joint Commission, 2010. 

Thoroughman DA, Frederickson D, Cameron D, Shelby L, Cheek, JE. (2002). Racial misclassification of American Indians in Oklahom

Sexually Transmitted Diseases. American Journal of Epidemiology, 155, 1137-1141. 

US Department of Veterans Affairs (2003). VHA Directive 2003-027, Capture of Race and Ethnicity Categories Washington, DC: US US Department of Veterans Affairs (2009). VHA Handbook 1601A.01, Intake Registration Washington, DC: U.S.Department of Vete

Veterans Health Administration Decision Support Office (2009). National Data Extract Technical Guide Bedford, MA: U.S. Departmen

Wei II, Virnig BA, John DA, Morgan RO. (2006). Using a Spanish surname match to improve identification of Hispanic women in Me

RESEARCHERS’ GU RESEARCHERS IDE TO VA DATA ’ GUIDE TO VA DATA 

Health Serv Res, 41, 1469-1481. 
Questions?

RESEARCHERS’ GUIDE TO VA DATA RESEARCHERS’ GUIDE TO VA DATA 
Upcoming Seminar

June 4 Using VA Corporate Data Using VA Corporate Data Wareho

Wareho

(CDW)to Assess Vitals (CDW)to Assess Vitals 

RESEARCHERS’ GUIDE TO VA DATA RESEARCHERS’ GUIDE TO VA DATA