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Hospitals study how to collect patient information to ensure equal health care for all

Toronto, October 18, 2013

By Kendra Stephenson

Tri-Hospital + TPH Health Equity Data Collection Research Project
We ask because we care: the Tri-Hospital + TPH Health Equity Data Collection Research Project
Summary Report (1.8 MB pdf file)
Full Compendium Report (3.9 MB pdf file)

Three Toronto hospital with diverse patient populations wanted to know how they could measure whether they were providing equal health care to all patients, regardless of their socio-economic status, race, gender or age.

Hospitals are required to report publicly on 200 indicators relating to patient safety, such as rates of hospital-acquired infections, hand hygiene compliance and hospital mortality rates. But the only demographic information collected on patients in Ontario is date of birth, gender and postal code.

This lack of data motivated St. Michael’s Hospital, the Centre for Addiction and Mental Health, and Mount Sinai Hospital, joined later by Toronto Public Health, to form the Tri-Hospital + TPH Health Equity Data Collection Research Project.

The group launched a pilot project to determine whether it was possible to collect more socio-demographic data on patients to accurately measure health equity and identify gaps by considering a variety of factors. Issues such as repeat visits to Emergency Departments among particular groups, or the relationship between income and health care access, can be examined using the collected information.

For example, if the data shows patients from one ethnic community are particularly high users of a hospital’s Emergency Department, the hospital’s community outreach team can work with the community to see why they aren’t using primary care physicians.

There are no standardized questions for collecting health-centred demographic data on patients in Canada and surprisingly, the group found there were no promising best practices internationally.

Developing specific questions was therefore extremely complex, with the Tri-Hospital + TPH committee eventually using the Toronto District School Board’s family census as a guide. A pilot project, launched in the summer of 2012, included questions about patients’ race, age, preferred language to speak and read, length of residency in Canada, housing status, disability status, religion, gender identity, sexual orientation and income.

Socio-demographic information was gathered from a variety of patient settings, using in-person interviews, paper copies and computer tablets. The sites included general internal medicine and a family medicine centre at Mount Sinai; a family practice outpatient clinic waiting room at St. Michael’s; the outpatient schizophrenia program at CAMH; and Toronto Public Health’s Healthiest Babies Possible Program.

Data was collected from1, 942 respondents from a total of 2,242 approached patients. The pilot project found that the vast majority, more than 85 per cent, of approached patients were willing to provide their socio-demographic information in the interest of improving health equity, experience and care for all patients.

The sample size in the pilot project was too small to draw conclusions on the relationship between socio-demographic factors and health care access and status. However, due to the pilot project’s success and potential for progressing health care, the Toronto Central Local Health Integration Network issued a directive requiring all of its 17 hospitals to collect this data from patients over the next two years.

The goals behind the examination of health equity and accumulation of specific patient data are to provide every patient with the best possible care; ensure health institutions welcome and accommodate all patients; track information to learn how health is impacted by factors such as language, disability and gender among diverse patient groups; and identify as well as reduce barriers to equitable care.

The collection and analysis of this information is crucial to the health care system’s ability to meet the diverse needs of Toronto’s population and improve the quality of health care overall. Moreover, hospitals are able to learn more about the patients they serve, and better meet their individual needs.

The Tri-Hospital + TPH Health Equity Data Collection Research Project Report is available for review on the participating institutions’ websites.

About St. Michael’s Hospital

St Michael’s Hospital provides compassionate care to all who enter its doors. The hospital also provides outstanding medical education to future health care professionals in 27 academic disciplines. Critical care and trauma, heart disease, neurosurgery, diabetes, cancer care, care of the homeless and global health are among the Hospital’s recognized areas of expertise. Through the Keenan Research Centre and the Li Ka Shing International Healthcare Education Centre, which make up the Li Ka Shing Knowledge Institute, research and education at St. Michael’s Hospital are recognized and make an impact around the world. Founded in 1892, the hospital is fully affiliated with the University of Toronto.

Media contacts

For more information, contact:

Kendra Stephenson
Communications and Public Affairs
416-864-6060 x7178
stephensonk@smh.ca