Racial and Ethnic Differences in Diagnostic Imaging Utilization During Adult Emergency Department Visits in the United States, 2005 to 2014.
J Am Coll Radiol
; 16(8): 1036-1045, 2019 Aug.
Article
em En
| MEDLINE
| ID: mdl-31092354
ABSTRACT
OBJECTIVE:
To compare the use of medical imaging (x-ray [XR], CT, ultrasound, and MRI) in the emergency department (ED) for adult patients of different racial and ethnic groups in the United States from 2005 to 2014.METHODS:
We performed a multilevel stratified regression analysis of the National Hospital Ambulatory Medical Care Survey ED Subfile, a nationally representative database of hospital-based ED visits. We examined race (white, black, Asian, other) and ethnicity (Hispanic versus non-Hispanic) as the primary exposures for the outcomes of ED medical imaging use (XR, CT, ultrasound, MRI, and any imaging). We controlled for other potential patient-level and facility-level determinants of ED imaging use.RESULTS:
Approximately half (48.8%) of the 225,037 adult patient ED visits underwent imaging; 36.1% underwent XR, 16.4% CT, 4.1% ultrasound, and 0.8% MRI. White patients received imaging during 51.3% of their encounters, black patients received imaging during 43.6% of their encounters, Asians received imaging during 50.8% of their encounters, and other races received imaging during 46% of their encounters. As compared with white patients, black patients had decreased adjusted odds of receiving imaging in the ED (odds ratio [OR] = 0.86, 95% confidence interval [CI] 0.84-0.89). Comparatively, black patients had a lower odds of CT scan (OR = 0.80, 95% CI 0.77-0.83) or MRI (OR = 0.74, 95% CI 0.65-0.85). Hispanic patients and Asian patients had a higher odds of receiving ultrasound (OR = 1.36, 95% CI 1.27-1.44 and OR = 1.25, 95% CI 1.10-1.42), respectively. IMPLICATIONS We observed significant racial and ethnic differences in medical imaging use in the ED even after controlling for patient- and facility-level factors.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Contexto em Saúde:
1_ASSA2030
/
2_ODS3
Problema de saúde:
1_acesso_equitativo_servicos
/
1_desigualdade_iniquidade
/
2_cobertura_universal
Assunto principal:
Diagnóstico por Imagem
/
Etnicidade
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Revisão da Utilização de Recursos de Saúde
/
Serviço Hospitalar de Emergência
Tipo de estudo:
Diagnostic_studies
Aspecto:
Equity_inequality
Limite:
Adult
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Aged
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Female
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Humans
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Male
/
Middle aged
País/Região como assunto:
America do norte
Idioma:
En
Revista:
J Am Coll Radiol
Assunto da revista:
RADIOLOGIA
Ano de publicação:
2019
Tipo de documento:
Article