Talk to the Veterans Crisis Line now
U.S. flag
An official website of the United States government

Health Services Research & Development

Veterans Crisis Line Badge
Go to the ORD website
Go to the QUERI website

2011 HSR&D National Meeting Abstract

Printable View

2011 National Meeting

3104 — VA Race and Ethnicity Data Consistency and Agreement with Survey Self-Report

Washington DL (VA Greater Los Angeles Healthcare), Lanto A (VA Greater Los Angeles Healthcare), Mitchell MN (VA Greater Los Angeles Healthcare), Riopelle D (VA Greater Los Angeles Healthcare), Sun S (VA Greater Los Angeles Healthcare)

Since 2003, VA has collected self-reported race and ethnicity data in compliance with a new Office of Management and Budget guideline. Resultant missing race/ethnicity values, and strategies for incorporating Medicare data to improve data completeness, have been examined. However, consistency across time of new VA race/ethnicity measures, and their agreement with survey self-report is unknown.

We linked 2006, 2007, and 2008: Survey of Healthcare Experiences of Patients (SHEP) surveys; VA Outpatient Visit Medical SAS datasets (VA-data); and External Peer Review Program (EPRP) data. SHEP provided self-reported race and ethnicity. VA-data were coded to incorporate race and ethnicity, and method of data collection. SHEP and VA-data both allowed multiple race reporting. For individuals with EPRP data and non-missing self-reported VA-data (n = 413,033), we calculated data consistency as the percentage of visits in which each race/ethnicity category (Hispanic, White, African-American, Asian, Native Hawaiian/Other Pacific Islander [NHOPI], American Indian/Alaskan Native [AIAN]) was coded (e.g., percent visits an individual was Hispanic). For the subgroup with 100% VA-data consistency and one SHEP survey (n = 87,138), we calculated percent agreement between VA-data and SHEP. Independently, for individuals with two SHEP surveys (n = 16,804), we calculated percent agreement between the two survey self-reports.

Individuals in the linked multi-year VA data had 56.6 mean visits (standard deviation 59.7). Race/ethnicity categories were 100% consistent across visits for 97.8% of individuals. This group was 78.8% White, 17.3% African-American, 5.1% Hispanic, 0.5% Asian, 0.7% AIAN, 0.9% NHOPI. Broadening race assignment based on the majority of an individual’s visits increased the number of NHOPIs 19%, AIANs 16%, Asians 5%, Hispanics 4%, African-Americans 2%, and Whites 1%. Concordance between two SHEP surveys was 95% for Whites, 97% for AIANs, and at least 99% for other groups. VA-data/SHEP concordance was similar.

Agreement of self-reported survey and VA-data is comparable to concordance in repeat surveys. Though VA race/ethnicity was highly consistent, race misclassification disproportionately affected smaller groups. Limiting race assignment to 100% consistent records, reduces the available sample from these groups.

Trade-offs exist between assigning race category only when 100% consistent, versus, based on the majority of records. This choice should be guided by the research or policy question.

Questions about the HSR&D website? Email the Web Team.

Any health information on this website is strictly for informational purposes and is not intended as medical advice. It should not be used to diagnose or treat any condition.