The Fund is also supporting work to identify high-performing health systems for racial and ethnic minorities by using the 10 hospital quality measures adopted by the National Voluntary Hospital Reporting Initiative. Researchers at the Health Research and Educational Trust are working with the private University HealthSystem Consortium to collect and analyze the quality data, which are stratified by race, ethnicity, and primary language to measure disparities in inpatient care. The research team is also conducting case studies to assess how individual hospitals respond to reporting quality data by race/ethnicity. Another research team, based at George Washington University, is developing protocols for using the reporting framework at six major public hospitals that treat large minority populations.

Patients who have limited proficiency in English or difficulty comprehending physician instructions and health information often experience problems accessing care. Many also receive lower-quality care or underutilize appropriate health services. With support from the Fund, Glenn Flores, M.D., from the Medical College of Wisconsin, found that parents with limited English proficiency (LEP) are three times more likely than English-proficient parents to have a child in fair or poor health, and twice as likely to have had a child spend one or more days in bed with an illness in the past year.⁽⁹⁾

Flores concluded that parental LEP is a more precise measure of language barriers in health care than the primary language spoken at home—and recommends that health plans routinely collect information on their patients' English proficiency to measure demand for interpreter services.