Objective Criteria for Identifying Ethnic Sub-populations: Assessing Hispanic Patients in Rural Practice Settings

Background: Family practice clinics serving minority populations in rural communities in West Texas are challenged by imprecise designations of patient ethnicity. Typically in these clinics, information on patient demography is collected as a function of the admission and billing systems. Ethnicity coding by clerks, based on arbitrary and subjective factors (surname, physical appearance), and confined to narrow categories (black, white, Hispanic, other), provides an inadequate basis for characterizing clinic populations, for conducting research on issues important to health disparity groups, and for effective community outreach.

Purpose: The project described in the poster proposed here was undertaken in order to improve the sensitivity and accuracy of record-keeping related to ethnicity on behalf of more than 500,000 persons seen each year in the region's primary care clinics.

Methods: Funded by the National Institutes of Health, state general revenue funds and private philanthropic gifts, this project seeks development of classifications of patient ethnicity that rely on the patient's self-report in current Census Bureau categories, supplemented by objective criteria using Census Bureau data, State or local collected data and relevant literature.

Results: The objective criteria include language-preference, nativity, degree of acculturation and generations in the United States, along with cultural and religious considerations. These factors, taken together, are weighted in an intensity algorithm that will enable quantification of the criteria and assessments of ethnic sub-populations.

Conclusion: Those objective criteria are expected to clarify the confusion existing in the current definitions of Hispanic ethnic subpopulation, and to provide more accurate information regarding the health of this population, therefore more appropriate health services programs can be designed.