Recording ethnicity in primary care: assessing the methods and impact

Hull, Sally; Mathur, Rohini; Badrick, Ellena; Robson, John; Boomla, Kambiz

doi:10.3399/bjgp11x572544

Cited by 26 publications

(27 citation statements)

References 11 publications

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“…The findings also support previous survey and interview research,4 7 8 11 suggesting that respondents can find ethnic self-identification using an open response format difficult and confusing. These findings suggest that respondents require clear guidance and a choice of ethnic categories in order to produce more stable responses to the ethnic monitoring question.…”

Section: Discussionsupporting

confidence: 85%

“…First, healthcare organisations have an interest, indeed a duty, to ensure equality of access to all healthcare services (ie, subsumed by the duty of all public bodies to consider the equality implications of the policies that shape their work1). Second, information about the ethnicity of patient populations can “provide vital information about the patterns of health and social indicators and provide an essential foundation for tackling health inequalities between different populations.”2 Furthermore, information about the ethnicity of individual patients/callers can enable healthcare organisations to target services, guidance and support appropriately, according to the known epidemiological patterns of incidence of particular diseases 3 4. However, there is evidence across a range of healthcare organisations that frontline staff experience difficulties in eliciting this information,5–8 and that partly as a consequence of these difficulties the information collected about ethnicity can be incomplete, inaccurate or unreliable 9.…”

Section: Introductionmentioning

confidence: 99%

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Improving ethnic monitoring for telephone-based healthcare: a conversation analytic study

et al. 2013

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ObjectivesMedical and healthcare organisations—including the national cancer support and helpline organisation that is the subject of this study—are expected to collect and monitor information about the ethnicity of their client populations. Information about ethnicity is important for a variety of reasons, including monitoring need and targeting healthcare services appropriately. Previous survey and interview research has suggested that collecting ethnicity data from service users can be incomplete and of variable quality—pointing to a need for an improved understanding of the (interactional) difficulties involved when call-handlers ask callers about their ethnicity.DesignThis study analyses a corpus of real-life audio-recorded calls to a national cancer helpline in the UK, focusing on the way that call-handlers collect the ethnic monitoring data.SettingA major national cancer helpline in the UK.ParticipantsA sample of 273 recorded calls were recorded, of which 267 were frontline calls in which call-handlers are expected to ask the ethnicity monitoring question.ResultsFindings suggest that caller uncertainty about how to answer the question, resistance to answering and call-handler presumption can compromise the effectiveness of ethnic monitoring. It is likely to be improved by changing how the ethnicity monitoring question is asked. Changes include avoiding open question formats to ease caller uncertainty; offering callers a rationale (account) for the question to minimise resistance and confirming the accuracy of the ethnic category recorded.ConclusionsWe recommend that telephone-based healthcare personnel avoid asking the ethnicity monitoring question in an ‘open’ format; instead, a question containing a (short) standardised list can assist callers in responding. A training tool has been developed that applies this and other findings, with a view to improving ethnic monitoring.

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Section: Discussionsupporting

confidence: 85%

Section: Introductionmentioning

confidence: 99%

Improving ethnic monitoring for telephone-based healthcare: a conversation analytic study

et al. 2013

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“…Completeness and quality of recording of self-reported ethnicity has been supported by local incentives, 29 and the availability of small area Census data for social deprivation has made it possible to consider both variables concurrently with a high degree of accuracy. The ethnic diversity of the population enhanced group comparisons further.…”

Section: Resultsmentioning

confidence: 99%

Ethnic and social disparity in glycaemic control in type 2 diabetes; cohort study in general practice 2004–9

et al. 2012

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SummaryObjective To determine whether ethnic group differences in glycated haemoglobin (HbA1c) changed over a 5-year period in people on medication for type 2 diabetes. Design Open cohort in 2004 -9.Setting Electronic records of 100 of the 101 general practices in two inner London boroughs.Participants People aged 35 to 74 years on medication for type 2 diabetes.Main outcome measures Mean HbA1c and proportion with HbA1c controlled to ≤7.5%.Results In this cohort of 24,111 people, 22% were White, 58% South Asian and 17% Black African/Caribbean. From 2004 to 2009 mean HbA1c improved from 8.2% to 7.8% for White, from 8.5% to 8.0% for Black African/Caribbean and from 8.5% to 8.0% for South Asian people. The proportion with HbA1c controlled to 7.5% or less, increased from 44% to 56% in White, 38% to 53% in Black African/ Caribbean and 34% to 48% in South Asian people. Ethnic group and social deprivation were independently associated with HbA1c. South Asian and Black African/Caribbean people were treated more intensively than White people.Conclusion HbA1c control improved for all ethnic groups between 2004-9. However, South Asian and Black African/Caribbean people had persistently worse control despite more intensive treatment and significantly more improvement than White people. Higher social deprivation was independently associated with worse control.

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“…18 Using the high levels of ethnicity recording (97%) in the population of under 5s, we did an analysis using bivariate statistics to examine differences in MMR vaccine uptake by ethnic group. 19 We did logistic regression analysis to determine whether the likelihood of receiving the MMR1 vaccine differed by ethnic group after adjustment for sex and social deprivation (measured using individual level Townsend scores based on the 2001 census).…”

Section: Analysis and Interpretationmentioning

confidence: 99%