PAMF Race/Ethnicity and Language Collection Study May Help Reduce Health Disparities

Article on study to be published in prestigious Health Services Journal

Palo Alto, Calif. – The Palo Alto Medical Foundation’s (PAMF’s) Palo Alto and Camino Divisions began collecting race/ethnicity and language information in May 2008 when scientific reports and studies showed that collection of such information improved quality of service and care by helping reduce racial/ethnic disparities.

An article documenting the collection efforts, which will serve as a model for other large, outpatient health care organizations, will be released in the October issue of Health Services Research, a top industry publication. Dr. Latha Palaniappan, Eric Wong, and Jessica Shin from the PAMF Research Institute’s Health Policy Research Department partnered with Maria Moreno, MPH, from Sutter Health Institute of Research and Education (SHIRE) and Regina Otero-Sabogal, PhD, from University of California, San Francisco, to author the paper.

“Government reports have documented that racial and ethnic minorities experience disparities in health, such as receiving poorer treatment for heart attacks or being more likely to be diagnosed with late-stage breast cancer and colorectal cancer,” said Moreno, a researcher at SHIRE. “If data on patients’ race/ethnicity and primary language are available, disparities in health care can be addressed.”

“The Patient Demographic Questionnaire is a one-time, optional questionnaire that a patient fills out when they are checking in for their appointment. It enables the patient to provide self-reported, demographic-specific information about themselves for their doctors, so that the doctors in turn can provide an even higher level of quality care to the patient depending on the prevalence of health conditions associated with their race/ethnicity,” said Michael Fagan, project manager in PAMF’s Palo Alto Division who worked closely with Kim MacIntosh, his counterpart in PAMF’s Camino Division, to implement the process.

Currently nearly one-third of PAMF patients have their race/ethnicity and language information linked to their electronic health records. This information minus the identity of the patient is being used to investigate health disparities in the treatment of diseases, such as diabetes and cardiovascular disease.

“PAMF is a pioneer in collecting race/ethnicity and language in a clinic setting. This study provides a pathway for implementation of race/ethnicity and language collection at other health care delivery systems,” says Dr. Palaniappan, a PAMF physician and research investigator. “Our goal is to use this study to develop a standard of care that takes into account the unique risk factors inherent in people of different races/ethnicities. The bottom line is that if we know a patient’s race/ethnicity, we can provide them with even better preventive care.”

As part of the study, PAMF conducted pilot programs on how to best collect patients’ race/ethnicity and language information, and decided to collect the optional form during patient registration. Mailing the questionnaire and a telephone questionnaire were also studied, but had a lower rate of completion.

“Implementing this data collection process was not easy or simple. We considered every aspect of the process very carefully including how the questions were presented, how Patient Service Representatives at the front desk would introduce the questionnaire, and how to best protect patient privacy,” said Wong, a senior statistician at the PAMF Research Institute. “Collecting this information from the patient right before their visit proved to be the most effective method and it freed up time for the doctor and the patient, enabling them to spend more time together discussing the reason for the appointment.”

To see the full article in print, please visit www.hsr.org.

For more information, contact:

Ben Drew
Palo Alto Medical Foundation
650-691-6228
drewb1@pamf.org