• J Am Coll Radiol · Aug 2019

    Racial and Ethnic Differences in Diagnostic Imaging Utilization During Adult Emergency Department Visits in the United States, 2005 to 2014.

    • Justin D Schrager, Rachel E Patzer, Joyce J Kim, Stephen R Pitts, Falgun H Chokshi, Joi S Phillips, and Xingyu Zhang.
    • Department of Emergency Medicine, Emory University School of Medicine, Atlanta, Georgia. Electronic address: jschrag@emory.edu.
    • J Am Coll Radiol. 2019 Aug 1; 16 (8): 1036-1045.

    ObjectiveTo compare the use of medical imaging (x-ray [XR], CT, ultrasound, and MRI) in the emergency department (ED) for adult patients of different racial and ethnic groups in the United States from 2005 to 2014.MethodsWe performed a multilevel stratified regression analysis of the National Hospital Ambulatory Medical Care Survey ED Subfile, a nationally representative database of hospital-based ED visits. We examined race (white, black, Asian, other) and ethnicity (Hispanic versus non-Hispanic) as the primary exposures for the outcomes of ED medical imaging use (XR, CT, ultrasound, MRI, and any imaging). We controlled for other potential patient-level and facility-level determinants of ED imaging use.ResultsApproximately half (48.8%) of the 225,037 adult patient ED visits underwent imaging; 36.1% underwent XR, 16.4% CT, 4.1% ultrasound, and 0.8% MRI. White patients received imaging during 51.3% of their encounters, black patients received imaging during 43.6% of their encounters, Asians received imaging during 50.8% of their encounters, and other races received imaging during 46% of their encounters. As compared with white patients, black patients had decreased adjusted odds of receiving imaging in the ED (odds ratio [OR] = 0.86, 95% confidence interval [CI]: 0.84-0.89). Comparatively, black patients had a lower odds of CT scan (OR = 0.80, 95% CI: 0.77-0.83) or MRI (OR = 0.74, 95% CI: 0.65-0.85). Hispanic patients and Asian patients had a higher odds of receiving ultrasound (OR = 1.36, 95% CI: 1.27-1.44 and OR = 1.25, 95% CI: 1.10-1.42), respectively.ImplicationsWe observed significant racial and ethnic differences in medical imaging use in the ED even after controlling for patient- and facility-level factors.Copyright © 2019 American College of Radiology. Published by Elsevier Inc. All rights reserved.

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