Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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Disparities are likely to present both in the emergency department and within the larger health care system; however, disparities must be recognized to be addressed. This article summarizes the proceedings from the AEM Consensus Conference 2003: Disparities in Emergency Health Care. ⋯ Participants were asked to describe the means of defining, assessing, measuring, and investigating disparities that may occur in emergency care. The committee members who wrote this report were asked to examine the influence of health care systems and administration on disparities in health care, using the following series of questions to frame the discussion. 1) Are all disparities bad? 2) Are only the vulnerable served inadequately by our current health care system? 3) Are what appear to be inequities really systems incompetence? 4) We assume there should be no inequality in health care: does society also assume this? 5) What would be the systems costs of equality in health care?
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Education is the means by which learning occurs and, thereby, behavior is changed. One means of improving health care disparities is changing the behavior and understanding of key personnel in academic health centers. These individuals influence policy and procedure, design and evaluate health systems, and define curricular standards for graduate and undergraduate medical education. ⋯ In addition to our responsibilities in educating emergency medicine residents, the emergency department also provides an ideal learning environment for medical students and other health care providers. The broad issue of disparities in emergency health care may be approached from a variety of directions. The Consensus Group on Education chose to focus on cultural competency education at several levels as a means of tangibly changing its status for both the immediate and long terms.
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To identify racial, ethnic, and gender disparities in the emergency department (ED) care for mild traumatic brain injury (mTBI). ⋯ There are significant racial and ethnic but not gender disparities in ED care for mTBI. The causes of these disparities and the relationship between these disparities and post-mTBI outcome need to be examined.
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To determine if there are any differences in proportion of high-acuity care and low-acuity care provided to uninsured, Medicaid-insured, and privately insured emergency department (ED) patients. ⋯ Whereas there were some statistically discerned differences between insurance groupings for proportionate receipt of low-acuity care and high-acuity care among both the pediatric and adult populations, the magnitude of most differences noted was not large, and may not reflect important differences in health care need or ED use based on insurance.
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The authors use data from the AIDS Costs and Service Utilization Survey (ACSUS) to investigate the extent to which use of ambulatory medical care is associated with inpatient and emergency department use among HIV-infected persons. ⋯ Outpatient care may offset inpatient and ED services at particular points in the disease course.