One area of concern within the state of Oklahoma is in the number of patients that have been misclassified on their health records, birth certificates, and death certificates. Many times, when a patient has expired, the funeral home director, doctor, nurse or EMS driver codes the patient’s death certificate; unaware of how important coding the correct race for each individual is. This also happens in admitting departments and nursing homes. These errors have caused an inaccurate account of incidence and mortality rates in racial categories on previous statistical data.
Miscoding in racial categories was identified to be nearly 50% on death certificates after data exchange with Tribal registries, linkage with the state death certificate database, and linkage with the Indian Health Services database, according to Dr. Janis Campbell, Surveillance Coordinator and Principal Investigator for the State of Oklahoma. She noted that this skews the numbers and it happens on a daily basis, which impacts incidence rates, mortality rates, and funding for services.
Once the error was corrected in the state database on all deceased cases, there was a 48.1% increase in the number of American Indians that had been diagnosed with cancer from 1997 forward. This increase caused the number in other races to decrease, giving a more accurate picture of the cancer burden in Oklahoma.