The majority of Canadian emergency departments (ED) do not systematically collect sociodemographic information such as race, ethnicity and language data on their patients, according to a new study led by UBC Department of Emergency Medicine (DEM) clinical instructor Dr. Niresha Velmurugiah.
The study, “Collection of patient race, ethnicity, and language data in emergency departments: a national survey”, was published in the Canadian Journal of Emergency Medicine (CJEM) and identifies the need for ongoing research and resources to address the paucity of race, ethnicity and language data collection in Canadian EDs.
While exploring a potential research study on how patients of different races and ethnicities and who speak different languages may receive different interventions or medical treatments for pain, Dr. Velmurugiah recognized that this topic could not be studied if the actual data does not exist.
How can we identify the problem if we don’t know the populations that we serve, she asked.
“In looking at research around racism in the health care system, I found that there was quite a lot of research in the US, UK and elsewhere but a paucity of research in Canada,” said Dr. Velmurugiah. “When I looked into this further, I realized that this was a national problem. Very little race and ethnicity data collection exists in many Canadian institutions, including hospitals.”
As an emergency physician, and given that the ED is a major point of contact for many patients accessing the health care system, Dr. Velmurugiah worked with a team of researchers to look specifically at EDs across the country and quantify the proportion that collect patient race, ethnicity and language data.
The team distributed a survey to all Canadian EDs and had a 32.8 per cent response rate. The results found that one fifth (20.3%) of responding EDs reported that they collected race and ethnicity data and 38.1% collected primary language data. Reported uses for these data included quality improvement, research, and direct patient care.
The survey results also found that EDs in areas with higher proportions of minority groups collected sociodemographic data at lower rates than EDs in other areas. The one exception was that EDs in areas with higher non-English/French populations collected language data, but not other sociodemographic data, at higher rates than EDs in other areas.
Dr. Velmurugiah notes that there are health care systems across the US and Canada that have adopted methods to collect patient sociodemographic data, and recognizes that there may be some discomfort around implementing new systems that would involve asking patients these types of questions.
“This is not something that there’s no precedent for,” she said. “If we’re transparent about the reasons why we’re collecting this data and how important it will be for advancing patient care and equity in patient care, then we could maintain patient trust and still obtain this crucial data.”
The study concludes that if Canadian hospitals prioritize improving their patient sociodemographic data collection systems, future studies that quantify the impact of race, ethnicity and language on patient health care treatment and outcomes will be possible.
“The issue of racism in Canada is not a new problem, but the acknowledgement of it is fairly new and many Canadian organizations have recently made commitments to addressing racism and discrimination in our health care system,” said Dr. Velmurugiah. “I hope this study brings about recognition that this type of data collection is something we’re lacking in our Canadian health care system and that we need to develop methods to allow for change to take place.”
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