دورية أكاديمية
Ambulance diversion and ED destination by race/ethnicity: evaluation of Massachusetts' ambulance diversion ban.
| العنوان: | Ambulance diversion and ED destination by race/ethnicity: evaluation of Massachusetts' ambulance diversion ban. |
|---|---|
| المؤلفون: | Hanchate AD; Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC, 27157-1063, USA. ahanchat@wakehealth.edu.; Section of General Internal Medicine, Boston University School of Medicine, Boston, MA, 02118, USA. ahanchat@wakehealth.edu., Baker WE; Department of Emergency Medicine, Boston University School of Medicine, Boston, MA, 02118, USA.; Boston Medical Center, Boston, MA, 02118, USA., Paasche-Orlow MK; Section of General Internal Medicine, Boston University School of Medicine, Boston, MA, 02118, USA.; Boston Medical Center, Boston, MA, 02118, USA., Feldman J; Department of Emergency Medicine, Boston University School of Medicine, Boston, MA, 02118, USA.; Boston Medical Center, Boston, MA, 02118, USA. |
| المصدر: | BMC health services research [BMC Health Serv Res] 2022 Aug 03; Vol. 22 (1), pp. 987. Date of Electronic Publication: 2022 Aug 03. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: BioMed Central Country of Publication: England NLM ID: 101088677 Publication Model: Electronic Cited Medium: Internet ISSN: 1472-6963 (Electronic) Linking ISSN: 14726963 NLM ISO Abbreviation: BMC Health Serv Res Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: London : BioMed Central, [2001- |
| مواضيع طبية MeSH: | Ambulance Diversion* , Emergency Medical Services*, Aged ; Emergency Service, Hospital ; Ethnicity ; Humans ; Massachusetts ; Medicare ; Minority Groups ; United States |
| مستخلص: | Background: The impact of ambulance diversion on potentially diverted patients, particularly racial/ethnic minority patients, is largely unknown. Treating Massachusetts' 2009 ambulance diversion ban as a natural experiment, we examined if the ban was associated with increased concordance in Emergency Medical Services (EMS) patients of different race/ethnicity being transported to the same emergency department (ED). Methods: We obtained Medicare Fee for Service claims records (2007-2012) for enrollees aged 66 and older. We stratified the country into patient zip codes and identified zip codes with sizable (non-Hispanic) White, (non-Hispanic) Black and Hispanic enrollees. For a stratified random sample of enrollees from all diverse zip codes in Massachusetts and 18 selected comparison states, we identified EMS transports to an ED. In each zip code, we identified the most frequent ED destination of White EMS-transported patients ("reference ED"). Our main outcome was a dichotomous indicator of patient EMS transport to the reference ED, and secondary outcome was transport to an ED serving lower-income patients ("safety-net ED"). Using a difference-in-differences regression specification, we contrasted the pre- to post-ban changes in each outcome in Massachusetts with the corresponding change in the comparison states. Results: Our study cohort of 744,791 enrollees from 3331 zip codes experienced 361,006 EMS transports. At baseline, the proportion transported to the reference ED was higher among White patients in Massachusetts and comparison states (67.2 and 60.9%) than among Black (43.6 and 46.2%) and Hispanic (62.5 and 52.7%) patients. Massachusetts ambulance diversion ban was associated with a decreased proportion transported to the reference ED among White (- 2.7 percentage point; 95% CI, - 4.5 to - 1.0) and Black (- 4.1 percentage point; 95% CI, - 6.2 to - 1.9) patients and no change among Hispanic patients. The ban was associated with an increase in likelihood of transport to a safety-net ED among Hispanic patients (3.0 percentage points, 95% CI, 0.3 to 5.7) and a decreased likelihood among White patients (1.2 percentage points, 95% CI, - 2.3 to - 0.2). Conclusion: Massachusetts ambulance diversion ban was associated with a reduction in the proportion of White and Black EMS patients being transported to the most frequent ED destination for White patients, highlighting the role of non-proximity factors in EMS transport destination. (© 2022. The Author(s).) |
| References: | Health Aff (Millwood). 2008 Mar-Apr;27(2):528-37. (PMID: 18332511) N Engl J Med. 2017 Apr 13;376(15):1441-1450. (PMID: 28402772) Ann Intern Med. 2007 Oct 16;147(8):573-7. (PMID: 17938396) Acad Emerg Med. 2013 Sep;20(9):911-9. (PMID: 24050797) Med Care. 2005 Apr;43(4):308-19. (PMID: 15778634) Prev Chronic Dis. 2013 Apr 25;10:E66. (PMID: 23618546) JAMA Netw Open. 2019 Sep 4;2(9):e1910816. (PMID: 31490537) Health Serv Res. 2015 Aug;50(4):1211-35. (PMID: 25495529) EMS World. 2011 Apr;40(4):31-8. (PMID: 22432213) Inquiry. 2010 Spring;47(1):81-91. (PMID: 20464956) Virtual Mentor. 2010 Jun 01;12(6):483-6. (PMID: 23158451) Ann Emerg Med. 2013 Mar;61(3):303-311.e1. (PMID: 23352752) BMJ Open. 2016 Mar 17;6(3):e010263. (PMID: 26988352) J Emerg Med. 2011 Mar;40(3):300-7. (PMID: 20385460) JAMA. 2014 Dec 10;312(22):2401-2. (PMID: 25490331) Health Aff (Millwood). 2009 Mar-Apr;28(2):w368-78. (PMID: 19258343) Health Serv Res. 2007 Aug;42(4):1613-31. (PMID: 17610440) Ann Emerg Med. 2006 Apr;47(4):317-26. (PMID: 16546615) Acad Emerg Med. 2006 Nov;13(11):1220-7. (PMID: 16946281) Health Aff (Millwood). 2017 Jun 1;36(6):1070-1077. (PMID: 28583966) Health Care Financ Rev. 2008 Spring;29(3):27-42. (PMID: 18567241) Health Aff (Millwood). 2012 Aug;31(8):1767-76. (PMID: 22869655) JAMA. 2008 May 14;299(18):2180-7. (PMID: 18477785) Health Aff (Millwood). 2008 Jul-Aug;27(4):w285-97. (PMID: 18522949) J Natl Cancer Inst. 2013 Dec 18;105(24):1891-6. (PMID: 24316600) Health Aff (Millwood). 2011 Oct;30(10):1904-11. (PMID: 21976334) Health Aff (Millwood). 2015 Aug;34(8):1273-80. (PMID: 26240239) J Polit Econ. 2015 Feb 1;123(1):170-214. (PMID: 25750459) Annu Rev Public Health. 2018 Apr 1;39:453-469. (PMID: 29328877) Health Serv Res. 2008 Aug;43(4):1388-402. (PMID: 18355259) Ann Emerg Med. 2017 Jan;69(1):44-51.e3. (PMID: 27497673) Arch Intern Med. 2007 Jun 11;167(11):1177-82. (PMID: 17563027) Ann Emerg Med. 2019 Mar;73(3):225-235. (PMID: 30798793) Prehosp Disaster Med. 2014 Feb;29(1):27-31. (PMID: 24451265) Acad Emerg Med. 2011 Sep;18(9):941-6. (PMID: 21906203) JAMA. 2011 Jun 15;305(23):2440-7. (PMID: 21666277) Health Serv Res. 2019 Aug;54(4):870-879. (PMID: 30941753) |
| معلومات مُعتمدة: | R01 HL127212 United States HL NHLBI NIH HHS; R01HL127212 United States HL NHLBI NIH HHS |
| فهرسة مساهمة: | Keywords: Disparity; Emergency department; Emergency medical services; Ethnicity; Race; Safety-net hospital; ambulance diversion |
| تواريخ الأحداث: | Date Created: 20220802 Date Completed: 20220804 Latest Revision: 20230714 |
| رمز التحديث: | 20230714 |
| مُعرف محوري في PubMed: | PMC9347077 |
| DOI: | 10.1186/s12913-022-08358-8 |
| PMID: | 35918721 |
| قاعدة البيانات: | MEDLINE |
Find this article in full text from Springer Verlag. 
Full Text Finder | تدمد: | 1472-6963 |
|---|---|
| DOI: | 10.1186/s12913-022-08358-8 |