The emergency department for routine healthcare: race/ethnicity, socioeconomic status, and perceptual factors
Department of Emergency Medicine
Medical Subject Headings
Adolescent; Adult; *African Continental Ancestry Group; Aged; Emergency Service, Hospital; Female; Health Care Surveys; Health Services Accessibility; *Hispanic Americans; Hospitals, University; Hospitals, Urban; Humans; Male; Middle Aged; New Jersey; Primary Health Care; Prospective Studies; Regression Analysis; Socioeconomic Factors; Urban Population
Our objective was to study the role of race/ethnicity and socioeconomic status (SES) in the use of the emergency department (ED) as a source of routine healthcare. Adult patients presenting to an urban ED were surveyed. We assessed demographics, race/ethnicity, SES, and perceptional factors related to choosing the ED for the current visit. Stepwise logistic regression analyses were used to explore whether SES accounted for racial/ethnic trends in ED use. Of 1375 patients, 936 (68%) were enrolled. After controlling for insurance status, income, employment status, and education, neither race nor ethnicity remained a strong predictor of routine ED use. Race/ethnicity-based disparities in routine ED use were due to the confounding effects of SES. Programs to reduce inappropriate ED use must be sensitive to an array of complex socioeconomic issues and may necessitate a substantial paradigm shift in how acute care is provided in low SES communities.
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Citation: J Emerg Med. 2007 Feb;32(2):149-58. Link to article on publisher's site