Determinants of emergency department use: are race and ethnicity important?
OBJECTIVE
To determine whether race/ethnicity is an important determinant of emergency department use.


METHODS
We conducted a cross-sectional survey in a public ED to determine self-reported ED visits over the preceding 3 months. The study group comprised consecutive ambulatory patients (N = 1,049) with nonemergency medical problems.


RESULTS
Blacks, whites, and Hispanics were equally likely to report one or more visits to an ED in the 3 months before study enrollment. Blacks were the most likely to report two or more ED visits in the preceding 3 months (19.0%), followed by whites (13.5%) and Hispanics (11.4%) (P = .01; unadjusted odds ratio, 1.82 for blacks versus Hispanics). In multivariate analysis, older age (P < .001), health insurance coverage (P < .001), regular source of care (P < .001), and difficulty obtaining transportation to a physician's office (P = .011) were positively associated with two or more previous ED visits. After adjustment for these variables, race/ethnicity was not significantly associated with ED use (P = .23; adjusted odds ratio for blacks versus Hispanics, 1.48 [95% confidence interval, .95 to 2.30]).


CONCLUSIONS
Race/ethnicity was not an important determinant of ED use after adjustment for age, health insurance coverage, regular source of care, and barriers to health care. Population-based studies of ED use should be conducted to further evaluate whether racial/ethnic differences in ED use exist that are not explained by differences in demographics, health, socioeconomic status, access to care, or other determinants of ED use.
Baker
D W
DW
Division of General Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.
Stevens
C D
CD
Brook
R H
RH
D000328:Adult; D001741:Black or African American; D000368:Aged; D002140:California; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005006:Ethnicity; D005260:Female; D006297:Health Services Accessibility; D006630:Hispanic or Latino; D006785:Hospitals, University; D006801:Humans; D007348:Insurance, Health; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D014186:Transportation; D044465:White People