Dataset Information

Racial and ethnic disparities in emergency department transfers to public hospitals.

ABSTRACT:

Objective

To examine racial/ethnic differences in emergency department (ED) transfers to public hospitals and factors explaining these differences.

Data sources and study setting

ED and inpatient data from the Healthcare Cost and Utilization Project for Florida (2010-2019); American Hospital Association Annual Survey (2009-2018).

Study design

Logistic regression examined race/ethnicity and payer on the likelihood of transfer to a public hospital among transferred ED patients. The base model was controlled for patient and hospital characteristics and year fixed effects. Models II and III added urbanicity and hospital referral region (HRR), respectively. Model IV used hospital fixed effects, which compares patients within the same hospital. Models V and VI stratified Model IV by payer and condition, respectively. Conditions were classified as emergency care sensitive conditions (ECSCs), where transfer is protocolized, and non-ECSCs. We reported marginal effects at the means.

Data collection/extraction methods

We examined 1,265,588 adult ED patients transferred from 187 hospitals.

Principal findings

Black patients were more likely to be transferred to public hospitals compared with White patients in all models except ECSC patients within the same initial hospital (except trauma). Black patients were 0.5-1.3 percentage points (pp) more likely to be transferred to public hospitals than White patients in the same hospital with the same payer. In the base model, Hispanic patients were more likely to be transferred to public hospitals compared with White patients, but this difference reversed after controlling for HRR. Hispanic patients were - 0.6 pp to -1.2 pp less likely to be transferred to public hospitals than White patients in the same hospital with the same payer.

Conclusions

Large population-level differences in whether ED patients of different races/ethnicities were transferred to public hospitals were largely explained by hospital market and the initial hospital, suggesting that they may play a larger role in explaining differences in transfer to public hospitals, compared with other external factors.

SUBMITTER: Hsuan C

PROVIDER: S-EPMC10915485 | biostudies-literature | 2024 Apr

REPOSITORIES: biostudies-literature

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Publications

Racial and ethnic disparities in emergency department transfers to public hospitals.

Hsuan Charleen C Vanness David J DJ Zebrowski Alexis A Carr Brendan G BG Norton Edward C EC Buckler David G DG Wang Yinan Y Leslie Douglas L DL Dunham Eleanor F EF Rogowski Jeannette A JA

Health services research 20240117 2

<h4>Objective</h4>To examine racial/ethnic differences in emergency department (ED) transfers to public hospitals and factors explaining these differences.<h4>Data sources and study setting</h4>ED and inpatient data from the Healthcare Cost and Utilization Project for Florida (2010-2019); American Hospital Association Annual Survey (2009-2018).<h4>Study design</h4>Logistic regression examined race/ethnicity and payer on the likelihood of transfer to a public hospital among transferred ED patient ...[more]

PMID: 38229568

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Dataset Information

Racial and ethnic disparities in emergency department transfers to public hospitals.

Objective

Data sources and study setting

Study design

Data collection/extraction methods

Principal findings

Conclusions

Publications

Racial and ethnic disparities in emergency department transfers to public hospitals.

Similar Datasets

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