Hospital Discharge Abstracts

Some 37 states collect discharge abstracts on patients admitted to nonfederal hospitals (that is, excluding VA and Department of Defense facilities). Approximately 85 percent of the states use a Uniform Bill for Hospitals (UB-92) format for collecting discharge data (AHRQ, 1999). Because the primary purpose of the UB-92 is to pay a claim, racial, ethnic, and socioeconomic data are not included in the UB-92 core billing standards. However, 27 states (55 percent) collected data on patient race and ethnicity as a part of their inpatient data using state fields.

Vital Statistics

All 50 states collect birth and death certificate data, and virtually all states provide the National Center for Health Statistics (NCHS) with racial, ethnic, and socioeconomic data from birth and death records. The standard certificates are defined by NCHS and data collection is specified in a certain way. Most states use the standard for reporting to NCHS, although there is variation at the local level. About 12 states collect data differently from the standard.

Cancer Registries

Forty-five states have cancer registries. The National Cancer Institute (NCI), through its Surveillance, Epidemiology, and End Results (SEER) program, sponsors 11 population-based registries. The Centers for Disease Control and Prevention, through its National Program of Cancer Registries (NPCR), sponsors registries where the NCI does not. Together, the two agencies cover 100 percent of the U.S. population. Many registries began in individual hospitals in accordance with guidelines established by the American College of Surgeons (ACoS) as part of the requirements for accreditation of oncology services. The main purpose of the hospital registry was to provide physicians with the data needed to maintain quality of care through peer review and to compare performance with recognized standards. Racial, ethnic, and socioeconomic characteristics are important data to epidemiologists who investigate cancer, so the categories are quite detailed. Differences in incidence rates among different racial, ethnic, and socioeconomic groups generate hypotheses for researchers to investigate.

Medicaid

All 50 states participate in the state-federal Medicaid program. Enrollment data include information on each beneficiary’s race, ethnicity, and



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