Bottom Line: Black and Hispanic Medicare patients transported by emergency medical services (EMS) to an emergency department (ED) were less likely to go to the same ED as white Medicare patients living in the same area. Evidence from previous studies has suggested differences in hospitals where racial/ethnic minorities receive care. Using Medicare claims data, this study looked at patterns of ED destination of EMS transport according to patient race/ethnicity and by zip code. The analysis included nearly 865,000 Medicare patients from 4,175 zip codes who had about 460,000 ED visits using EMS transport from 2006 to 2012. Authors report the proportion of white patients transported to the most frequent ED destination was 61.3%, while the proportion was 5.3% lower for black patients and 2.5% lower for Hispanic patients. A similar pattern was found among patients with high-risk acute conditions. Black and Hispanic Medicare patients also were more likely to be transported to a safety-net ED compared to white Medicare patients from the same zip code. Study limitations include that for certain clinical conditions (such as trauma, stroke and cardiac events), guidelines may require transportation to a suitable ED, which may not be near a patient's home.
Authors: Amresh D. Hanchate, Ph.D., Boston University School of Medicine, and coauthors
(doi:10.1001/jamanetworkopen.2019.10816)
Editor's Note: The article includes conflict of interest and funding/support disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
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Media advisory: To contact corresponding author Amresh D. Hanchate, Ph.D., email David Kibbe at david.kibbe@bmc.org. The full study is linked to this news release.
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