Understanding of Care and County Race Demographics

Studies have shown persistent disparities regarding effective treatment, care coordination, patient-safety, person-centered care, healthy living, and care affordability based upon race and ethnicity (AHRQ, 2018, Carratala, 2020). Research has demonstrated an association between socioeconomic status and health status, as well as the complexities of the socioeconomic status and race/ethnicity interplay on health outcomes (Anderson et al., 2004, Evans et al., 2016). Studies have identified a relationship between a variety of social and environmental factors and health outcomes, including risk of COVID-19 (Rubin, 2016, Henning-Smith et al., 2020). Health disparities are significantly related to factors such as education, race, ethnicity, and occupation – variables that continue to be measured as the U.S. works to implement change (Adler & Cutler, 2016, Artiga, 2019).

Analyzing the Data

Language-based barriers, race, and ethnicity disparities exist in health care (HCUP, 2016). The purpose of this assessment is to determine if there is a difference in the relationship between the percent of the population that reported they strongly understood discharge instructions compared to the percentage of the population for the race categories at the county level.

This data is also available in a text-based table format.

Tutorial: Using the Data

Data Sources

Hospital Compare - Patient Surveys - HCAHPS (data released July, 2020)

County Health Ranking (data released 2020)

Defining the Columns

A blank entry indicates unreported data. A value of zero is a defined value and does not represent unreported data.

State: The abbreviation of the state where the hospital is located.

County: The name of the county where the hospital is located. County names are listed as provided on the U.S. Census Bureau's list of 2019 FIPS Codes for Counties and County Equivalent Entities.

Hospital: The name of the hospital.

Percent Strongly Agree Understood Care: The percentage of patients who reported on the HCAHPS survey that they "Strongly Agree" they understood their care when they left the hospital. This data is from the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey about patient experience and satisfaction. The reporting period for this measure is July 1, 2018 through June 30, 2019.

Number of Completed Surveys: The number of completed HCAHPS surveys by patients for the specific hospital. The number must be greater than 25 to be reported in data.

Percent Asian: The proportion of the county’s population that falls into the race or ethnicity category of Asian from the U.S. Census Bureau Population Estimates from 2018.

Percent Black: The proportion of the county’s population that falls into the race or ethnicity category of Black from the U.S. Census Bureau Population Estimates from 2018.

Percent Hispanic: The proportion of the county’s population that falls into the race or ethnicity category of Hispanic from the U.S. Census Bureau Population Estimates from 2018.

Percent Native Hawaiian or Other Pacific Islander: The proportion of the county’s population that falls into the race or ethnicity category of Native Hawaiian or Other Pacific Islander from the U.S. Census Bureau Population Estimates from 2018.

Percent Native American: The proportion of the county’s population that falls into the race or ethnicity category of Native American from the U.S. Census Bureau Population Estimates from 2018.

Percent White: The proportion of the county’s population that falls into the race or ethnicity category of White from the U.S. Census Bureau Population Estimates from 2018.

This project is/was supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number UB1RH24206, Information Services to Rural Hospital Flexibility Program Grantees, $1,009,121 (0% financed with nongovernmental sources). This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.