- In the emergency department (ED), black patients with chest pain are less likely than white patients to undergo electrocardiogram (EKG).
- Patients with public or no insurance are less likely than privately insured to receive standard chest-pain care.
Why this matters
- Previous studies documenting disparities in triage, testing of chest-pain patients are older and did not adjust for clinical confounders.
- Compared with white patients, black patients were less likely to receive EKG: aOR, 0.82 (95% CI, 0.69-0.99).
- Compared with privately insured:
- Medicare recipients were less likely to be triaged emergently or receive EKG or cardiac enzymes.
- Medicaid recipients were less likely to be triaged emergently.
- Uninsured were less likely to receive EKG.
- Above adjusted for age, sex, region, payment, comorbidities, year.
- Similar but attenuated results after additional adjustment for vital signs, pain severity (n=8189).
- Analysis of ED data in annual National Hospital Ambulatory Health Care Surveys, 2009-2015 (n=10,441; representing 51.4 million US patients).
- Authors assessed records of adults presenting with chest pain and/or similar complaints of potential cardiac origin.
- Outcomes: triage acuity, evaluation with EKG, and cardiac enzymes.
- Funding: None.
- Retrospective, cross-sectional, so no causal information.
- Data on, e.g., pain descriptors unavailable.