THE EXPANDED RACIAL AND ETHNIC CODES IN THE MEDICARE DATA FILES - THEIR COMPLETENESS OF COVERAGE AND ACCURACY

Objectives. This paper evaluates the new race/ethnicity codes for Asia n Americans, Hispanics, and Native Americans that have recently been a dded to the Medicare enrollment database. Methods. The race/ethnicity code revisions made by the Health Care Financing Administration are de scribed and evaluated by (1) comparing the numbers of persons identifi ed as Asian Americans, Hispanics, and Native Americans with correspond ing population census projections and (2) determining whether Medicare enrollees born in Asian and Hispanic countries are assigned Asian and Hispanic codes. Results. Among persons 65 years of age and older, app roximately 24% of Hispanics, 17% of Native Americans, and 56% of Asian Americans are identifiable by the new codes. From 18% to 29% of enrol lees 65 years old or older born in Mexico, Puerto Rico, and Cuba are c oded as Hispanic, and from 14% to 73% of enrollees born in nine Asian countries are classified as Asian American. Classification is not rand om but is related to timing of migration and to country of origin. Con clusions. Researchers should resist the temptation to base analyses on the revised Health Care Financing Administration race/ethnicity codes , since coverage is incomplete and biased.