SHM Converge Scientific Abstract ePoster Gallery-Stability of Reported Race and Ethnicity Data Over Time at U.S. Children's Hospitals

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This retrospective cohort study examined how often recorded race or ethnicity changed across encounters in U.S. children’s hospitals using the PHIS database. The goal was to measure inconsistency in race and ethnicity documentation and identify factors associated with changes over time.<br /><br />The study included 10,360,050 patients aged 21 years or younger who had at least two emergency department, inpatient, or ambulatory surgery encounters between 2010 and 2024, across 43 hospitals with complete data. The primary outcome was any change in recorded race or ethnicity across encounters.<br /><br />Overall, 1,920,257 patients, or 18.5%, had at least one change in recorded race or ethnicity. Children with changes were more likely to have race or ethnicity initially recorded as Other, Missing, or Hispanic/Latino, and were more likely to have public insurance. They also tended to have more encounters and longer intervals between encounters.<br /><br />Among patients who experienced a change, transitions were most common for those with missing race/ethnicity data (75.3%) and American Indian/Alaska Native designations (61.0%). Changes were least common among Black patients (16.6%) and Asian patients (10.4%). There was also substantial institutional variation, with the proportion of patients experiencing any change ranging from 3.0% to 55.0% across hospitals.<br /><br />The authors conclude that nearly 1 in 5 pediatric patients had inconsistent race or ethnicity documentation over time, highlighting the dynamic and often unstable nature of these data in hospital systems. Such inconsistency may obscure disparities and affect equity analyses. The study emphasizes the need for standardized, patient-centered race and ethnicity data collection practices to improve data quality and support equitable pediatric care.

Asset Subtitle

Katie L. Butler

Meta Tag

Author List Barbara Chaiyachati, Colleen K. Gutman, John R. Stephens, Katie L. Butler, Magaret Samuels-Kalow, Matt Hall, Priyanka Joshi, Rama Salhi

Category Research

Concept Race and Ethnicity Data

Concept Health Disparities

Concept Retrospective Cohort Study

Concept Standardized Data Collection

Concept Resource Allocation

Distinguished Non-Finalist

Presenter Organization University of North Carolina

Presenting Author Katie L. Butler

Track Pediatric

Keywords

pediatric race and ethnicity

documentation inconsistency

retrospective cohort study

children’s hospitals

PHIS database

race ethnicity changes

health data quality

health equity

hospital variation

patient demographics

Race and Ethnicity Data

Health Disparities

Retrospective Cohort Study

Standardized Data Collection

Resource Allocation