Ethnicity data consultation findings Implications for ethnicity data users and recorders Alicia Webb Team Leader - Identity Data Management, Information Directorate HINZ Conference, 2008 © 2003 melissa gardi

Health System ethnicity data Uses Trend tracking by ethnicity Health outcomes improvement monitoring Health service targeting Ethnic group participation and contribution Role of Standards Data accuracy and consistency – time and datasets Consistency with Statistics NZ

Uses

Trend tracking by ethnicity

Health outcomes improvement monitoring

Health service targeting

Ethnic group participation and contribution

Role of Standards

Data accuracy and consistency

– time and datasets

Consistency with Statistics NZ

About the Consultation Series of questions on proposed changes to align Statistics NZ and Health ethnicity Standards advantages & disadvantages information and training needs challenges for implementation Stakeholder responses Wide variety, mostly collective responses 38 submissions in total

Series of questions on proposed changes to align Statistics NZ and Health ethnicity Standards

advantages & disadvantages

information and training needs

challenges for implementation

Stakeholder responses

Wide variety, mostly collective

responses

38 submissions in total

Key response themes Poor understanding of ethnicity Variable collection and recording processes Ethnicity data highly valued Acceptance of codeset changes Concerns about New Zealander category Preference for Level 4 recording Preference for not increasing number of ethnicity fields Preference for retaining multiple response prioritisation Importance of co-ordinated change management Criticality of training and support

Poor understanding of ethnicity

Variable collection and recording processes

Ethnicity data highly valued

Acceptance of codeset changes

Concerns about New Zealander category

Preference for Level 4 recording

Preference for not increasing number of ethnicity fields

Preference for retaining multiple response prioritisation

Importance of co-ordinated change management

Criticality of training and support

Understanding of Ethnicity Not a specific question within consultation but extensive comment Meaning of ethnicity – conceptual and contextual leads to complexity Purpose and benefits of ethnicity data collection and recording Public perception about the politics of ethnicity

Not a specific question within consultation but extensive comment

Meaning of ethnicity – conceptual and contextual leads to complexity

Purpose and benefits of ethnicity data collection and recording

Public perception about the politics of ethnicity

Variable collection & recording processes Situational context – frontline tension and confusion Standards and training to guide behaviours Standardised tools and processes IT systems support Administrative vs survey settings

Situational context – frontline tension and confusion

Standards and training to guide behaviours

Standardised tools and processes

IT systems support

Administrative vs survey settings

Ethnicity data highly valued Despite inherent difficulties, high value placed on ethnicity data by Health System stakeholders strong reaction to threats to time-series data quality (ie inclusion of New Zealander category) strong desire for improving granularity ie Level 4 recording strong desire for improving understanding, processes and training

Despite inherent difficulties, high value placed on ethnicity data by Health System stakeholders

strong reaction to threats to time-series data quality (ie inclusion of New Zealander category)

strong desire for improving granularity ie Level 4 recording

strong desire for improving understanding, processes and training

Acceptance of codeset changes Mandatory new codeset – technical changes across whole of Health System Concern about potential for New Zealander category future visibility at Level 2 Varied views on residual codes correct use, value and training burden improve granularity, reduce collection tension, specificity for health

Mandatory new codeset – technical changes across whole of Health System

Concern about potential for New Zealander category future visibility at Level 2

Varied views on residual codes

correct use, value and training burden

improve granularity, reduce collection tension, specificity for health

Concerns about New Zealander category Not a specific consultation question but considerable feedback received New Zealander as an ethnic category - introduction of code at Level 4 and aggregation to Other at Level 2 No change in collection process but social marketing @ census Potential impact on data quality and time-series data – consistency and continuity

Not a specific consultation question but considerable feedback received

New Zealander as an ethnic category - introduction of code at Level 4 and aggregation to Other at Level 2

No change in collection process but social marketing @ census

Potential impact on data quality and time-series data – consistency and continuity

Preference for level 4 recording General agreement but need to assess costs/benefits Improved information to support planning, funding and service delivery Improved granularity supports ability to reduce inequalities Need ability to continue outputting ethnicity data at all levels as appropriate

General agreement but need to assess costs/benefits

Improved information to support planning, funding and service delivery

Improved granularity supports ability to reduce inequalities

Need ability to continue outputting ethnicity data at all levels as appropriate

Preference for not increasing number of ethnicity fields Mixed views indicate need to assess costs/benefits Accuracy improves information to support planning, funding and service delivery Completeness improves comparability with other Government datasets Need to relate number of fields to changes in response prioritisation process

Mixed views indicate need to assess costs/benefits

Accuracy improves information to support planning, funding and service delivery

Completeness improves comparability with other Government datasets

Need to relate number of fields to changes in response prioritisation process

Preference for retaining multiple response prioritisation Unanimous disagreement with input randomisation method introduced within the Standard Data loss issues Strong support to maintain existing prioritisation methods in Health System

Unanimous disagreement with input randomisation method introduced within the Standard

Data loss issues

Strong support to maintain existing prioritisation methods in Health System

Importance of co-ordinated change management Challenges of change funding Challenges of staff support and training Desire for leadership and co-ordination of all agreed ethnicity changes Desire to reduce risks around systems development and change Desire for staged implementation to reduce cost and resource burden

Challenges of change funding

Challenges of staff support and training

Desire for leadership and co-ordination of all agreed ethnicity changes

Desire to reduce risks around systems development and change

Desire for staged implementation to reduce cost and resource burden

Criticality of training and support Role of frontline staff Potential exacerbation of existing collection and recording issues Great variance in preferred methods of training and support IT support and enablement

Role of frontline staff

Potential exacerbation of existing collection and recording issues

Great variance in preferred methods of training and support

IT support and enablement

Implications for the Health System Continue coding at Level 2 with new codeset from 1 July 2009 Adoption of all residual codes within new codeset with guidance for use in Health System Continue recording up to 3 ethnicities from 1 July 2009 Continue practice of input prioritisation Enable reporting and outputting of ethnicity data at all levels held

Continue coding at Level 2 with new codeset from 1 July 2009

Adoption of all residual codes within new codeset with guidance for use in Health System

Continue recording up to 3 ethnicities from 1 July 2009

Continue practice of input prioritisation

Enable reporting and outputting of ethnicity data at all levels held

Implications for the Health System Future system development capability and change Further work required on Consideration of optional to mandatory requirements for the Health System Possible use of input randomisation Assessment of ongoing training and support needs Ministry-led change co-ordination

Future system development capability and change

Further work required on

Consideration of optional to mandatory requirements for the Health System

Possible use of input randomisation

Assessment of ongoing training and support needs

Ministry-led change co-ordination

Next Steps Scoping activity - Stage 1 implementation proposed for 1 July 2009, including: Codeset changes Ethnicity Data Protocols revision Training and support for new codeset implementation and to sustain ongoing data quality Further work on impact and cost-benefit analysis and associated training needs © 2003 melissa gardi

Scoping activity - Stage 1 implementation proposed for 1 July 2009, including:

Codeset changes

Ethnicity Data Protocols revision

Training and support for new codeset implementation and to sustain ongoing data quality

Further work on impact and cost-benefit analysis and associated training needs