Saturday, February 10, 2007

The ED, It's not black or white...

Does race and gender matter when it comes to the treatment of chest pain in the Emergency Department? A study released yesterday by Drs Pezzin, Keyl, and Green in Academic Emergency Medicine evaluated the care rendered to patients with chest pain. They conclude that African-American men and women do not receive the same workup as non-African-American patients. Such deficiencies included delayed or absent ECG's, pulse oximetry, chest radiograph, and cardiac monitoring.

The study is retrospective and the patient population is drawn from the National Hospital Ambulatory Health Care Survey of Emergency Departments (NHAMCS-ED) for 1995–2000. I wonder how this population corresponds to New York City's?

BACKGROUND: The existence of race and gender differences in the provision of cardiovascular health care has been increasingly recognized. However, few studies have examined whether these differences exist in the emergency department (ED) setting.
CONCLUSIONS: This study documents race, gender, and insurance differences in the provision of electrocardiography and chest radiography testing as well as cardiac rhythm and oxygen saturation monitoring in patients presenting with chest pain. These observed differences should catalyze further study into the underlying causes of disparities in cardiac care at an earlier point of patient contact with the health care system.
Reuters news service published a commentary about the study

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