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Misclassification of data did not produce large variations in SMM rates for most racial and ethnic groups at the state level, but Non-Hispanic-American Indian or Alaska Native women showed a sizable difference (787%). Nonetheless, at the hospital level, Hispanic women demonstrated considerable disparity in the percentage difference of SMM rates, and were more prone to underestimating their SMM rates. The avoidance of misclassifying race and ethnicity on patient records is