Determinants of Emergency Department Use: Are Race and Ethnicity Important?, , ,

Study 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 physicianʹs 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]). Conclusion: 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 DW, Stevens CD, Brook RH: Determinants of emergency department use: Are race and ethnicity important? Ann Emerg Med December 1996;28:677-682.]