Blustein J
College of Physicians and Surgeons, Columbia University, New York, NY 10032.
Am J Public Health. 1994 Jun;84(6):1018-21. doi: 10.2105/ajph.84.6.1018.
Many studies demonstrating an association between race and the use of medical services have used hospital discharge abstract data. The quality of the measures of race in such data sources has heretofore been unexplored. Hospital discharge abstract data from New York State were used to identify 767 cardiac patients who had been admitted to a hospital twice. Racial classifications during the two admissions were concordant 93.7% of the time. Kappa was .89 for Blacks, .72 for Whites, and .43 for all other racial groups. Evidence suggests that the misclassification of race in hospital discharge abstract data is nondifferential; racial discrepancies in access to medical services are thus probably even greater than those previously reported.
许多表明种族与医疗服务使用之间存在关联的研究都使用了医院出院摘要数据。迄今为止,此类数据源中种族衡量指标的质量尚未得到探究。利用纽约州的医院出院摘要数据,识别出767名曾两次入院的心脏病患者。两次入院期间的种族分类在93.7%的情况下是一致的。黑人的卡帕值为0.89,白人为0.72,所有其他种族群体为0.43。有证据表明,医院出院摘要数据中种族的错误分类是无差异的;因此,获得医疗服务方面的种族差异可能比之前报道的更大。