The emergency department for routine healthcare: Race/ethnicity, socioeconomic status, and perceptual factors

Hong, Rick; Baumann, Brigitte M.; Boudreaux, Edwin D.

doi:10.1016/j.jemermed.2006.05.042

« Previous Next »The Journal of Emergency Medicine
Volume 32, Issue 2 , Pages 149-158, February 2007

The emergency department for routine healthcare: Race/ethnicity, socioeconomic status, and perceptual factors

Abstracts presented at the National ACEP Research Forum 2003, Boston, MA, October 13, 2003.

Rick Hong, MD
- Department of Emergency Medicine, University of Medicine & Dentistry of New Jersey (UMDNJ)-Robert Wood Johnson Medical School, Camden, New Jersey
- Cooper Hospital, Camden, New Jersey
Brigitte M. Baumann, MD
- Department of Emergency Medicine, University of Medicine & Dentistry of New Jersey (UMDNJ)-Robert Wood Johnson Medical School, Camden, New Jersey
- Cooper Hospital, Camden, New Jersey
Edwin D. Boudreaux, PHD
- Department of Emergency Medicine, University of Medicine & Dentistry of New Jersey (UMDNJ)-Robert Wood Johnson Medical School, Camden, New Jersey
- Cooper Hospital, Camden, New Jersey
- Department of Psychiatry, UMDNJ-Robert Wood Johnson Medical School, Camden, New Jersey
- Reprint Address: Edwin D. Boudreaux, phd, Emergency Medicine, Cooper Hospital, One Cooper Plaza, Camden NJ, 08103

Received 13 January 2005; received in revised form 18 October 2005; accepted 31 May 2006.

Abstract

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.

Keywords: utilization, routine care, overcrowding, race, ethnicity, emergency department