Racial/Ethnic Variation Found in ED Destination of EMS Transport

There is racial/ethnic variation in the emergency department destination for patients using emergency medical services (EMS) transport, according to a study published online in JAMA Network Open.

Amresh D. Hanchate, Ph.D., from the Boston University School of Medicine, and colleagues examined patterns in the emergency department destination of EMS transport according to patient race/ethnicity. Data were included for 864,750 patients aged 66 years or older with continuous fee-for-service Medicare coverage from 4,175 selected zip codes who had 458,701 emergency department visits using EMS transport.

The researchers found that 61.3 percent of white patients were transported to the reference emergency department; this rate was lower among black and Hispanic enrollees (difference, −5.3 and −2.5 percent, respectively). Among patients with high-risk acute conditions, a similar pattern was found: The proportion transported to the reference emergency department was 61.5 percent among white enrollees and lower among black and Hispanic enrollees (difference, −6.7 and −2.6 percent, respectively). A larger black-white discordance in emergency department destination was observed in major U.S. cities (−9.3 percent). Compared with their white counterparts, black and Hispanic patients were more likely to be transported to a safety-net emergency department.

"Future research is needed to understand the reasons for the divergence in emergency department destination by EMS transport and the extent to which this divergence may be associated with patient outcomes; the results of such research may inform the development of better EMS protocols," the authors write.

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