A special newsletter takeover by published authors
 â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â
Problems viewing this email?
View Message In Browser
<[link removed]>
Monday, February 13, 2023 | The Latest Research, Commentary, And News
From Health Affairs
Dear John,
Today's newsletter comes from Lawrence H. Brown, a professor at the
University of Texas at Austin, and Remle P. Crowe, the Director of
Clinical and Operational Research at ESO.
Differences In Ambulance Transport Destinations
[link removed]
In this month's issue of Health Affairs, we look into differences in
ambulance transport destinations
<[link removed]>
for White and racial or ethnic minority patients.
Our research broadly aims to improve the delivery of emergency medical
services (EMS), including studies of patient-level interventions, EMS
systems design, and EMS-related health policy.
We are not experts in health disparities, but we understand disparities
can manifest across the full spectrum of health care, including EMS
care.
We were inspired by the work of Amresh Hanchate and colleagues
<[link removed]>,
who reported that Black Medicare enrollees transported by ambulance were
approximately 5 percent less likely to be taken to the primary receiving
hospital for White patients residing in the same ZIP code.
Hispanic patients were nearly 3 percent less likely to be taken to the
primary receiving hospital for White patients.
Our goal was to evaluate disparities in transport destinations in a
broader sample of patients of all ages, regardless of payor, and using
the ZIP code of the emergency scene location as the geographic unit of
analysis.
We also used a different analytic tool, the Dissimilarity Index, which
allowed us to measure unevenness in the distributions of patients across
all the available destination hospitals.
We studied more than 3 million ambulance transports from 2,813 ZIP
codes.
In half of the studied ZIP codes, at least 8 percent of racial or ethnic
minority patients would have had to have been transported to a different
hospital to achieve even distribution of White and minority patients
across the available destination hospitals.
In two out of five ZIP codes, the discordance in transport destinations
exceeded 10 percent.
We cannot conclude from our data that these discordances in ambulance
transport destinations result in disparities in medical care or
outcomes, but previous studies have demonstrated that differences in
where White and minority patients receive medical care can contribute to
disparities in care.
We have no reason to think that is different for patients transported by
ambulance.
We support efforts to increase EMTs' and paramedics' awareness of their
own implicit biases, and efforts to increase diversity, equity, and
inclusion among the EMS workforce.
However, we want to emphasize these data most likely reflect systemic
factors influencing patients' health care journeys, and not explicit
encounter-level decisions to transport White and racial or ethnic
minority patients to different hospitals.
There can be good reasons for transporting patients from within the same
ZIP code to different hospitals, but in the absence underlying systemic
drivers, we would expect those factors to be nearly evenly distributed
among White and racial or ethnic minority patients.
It appears that EMS encounters with racial or ethnic minority patients
are as susceptible as the rest of health care to the effects of
disproportionate poverty, reduced access to employment and health
insurance, geographic segregation, and even historical segregation and
racism within the health care system.
This matters: More than 20 million patients are transported to a
hospital by EMS each year, and millions more receive medical evaluations
and on-scene care without transport.
Identifying this phenomenon is only a beginning.
We hope that our work will further inspire those who are experts in
health disparities to incorporate the EMS phase of care in their ongoing
efforts to study, mitigate, and eliminate disparities related to race
and ethnicity.
Learn More
<[link removed]>
Health Affairs Branded Post:
Bold Action Can Fix Our Healthcare System
<[link removed]>
Chris Chen
Sponsored by ChenMed <[link removed]>
Â
Â
Elsewhere At Health Affairs
Today in Forefront, Noa Krawczyk and coauthors propose immediate and
long-term investments
<[link removed]>
that local jurisdictions can make with opioid settlement funds to
address opioid use disorder in their communities.
If you're enjoying articles from Forefront, you can bookmark the website
<[link removed]> to never miss an article.
[link removed]
Daily Digest
Ambulance Transport Destinations In The US Differ By Patient Race And
Ethnicity
<[link removed]>
Christine E. Pack et al.
Optimizing Opioid Settlement Funds To Save Lives: Investing In Equitable
Solutions
<[link removed]>Noa
Krawczyk et al.
[link removed]
Last week's quiz <[link removed]> asked "A benefit
design strategy that reduces patients' out-of-pocket spending
requirements for high-value care is known as... "
The answer? Value-based care.
Read more about value-based care and payment
<[link removed]>.
[link removed]
[link removed]
Â
[link removed]
Â
[link removed]
Â
[link removed]
Â
mailto:
[email protected]
About Health Affairs
Health Affairs is the leading peer-reviewed journal
<[link removed]> at the intersection of health,
health care, and policy. Published monthly by Project HOPE, the journal
is available in print and online. Late-breaking content is also found
through healthaffairs.org <healthaffairs.org>, Health Affairs Today
<[link removed]>, and Health Affairs Sunday
Update <[link removed]>. Â
Project HOPE <[link removed]> is a global health and
humanitarian relief organization that places power in the hands of local
health care workers to save lives across the globe. Project HOPE has
published Health Affairs since 1981.
Copyright © Project HOPE: The People-to-People Health Foundation, Inc.
Health Affairs, 1220 19th Street, NW, Suite 800, Washington, DC 20036, United States
Privacy Policy <[link removed]>
To unsubscribe from this email, update your email preferences here
<[link removed]>.
_________________
Sent to
[email protected]
Unsubscribe:
[link removed]
Health Affairs, 1220 19th Street, NW, Suite 800, Washington, DC 20036, United States
