No Differences Found In Trauma Patient Care Among Patients Of Different Ethnicities

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Article Date: 19 Nov 2008 - 0:00 PDT

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A study published in the November issue of Archives of Surgery finds that non-Hispanic white patients and patients from minority ethnic groups in the US receive a similar level of trauma care. Shahid Shafi, M.D., M.P.H., and Larry M. Gentilello, M.D. (University of Texas Southwestern Medical School, Dallas) find no significant disparities in initial evaluations or injury management between the groups.

"Ethnic disparities in our health care system have been well documented in treatment of several diseases, such as coronary artery disease, congestive heart failure, renal failure, acute appendicitis and organ transplant," write the authors. "These disparities range from limited access to health care to lower use of evidence-based therapies and a lower rate of invasive procedures."

Analyzing data on 8,563 trauma patients from a 2003 national survey, Shafi and Gentilello investigated differences in the initial assessment and management of injuries among patients of different ethnicities. The sample consisted of 6,106 non-Hispanic white patients, 1,406 African American patients, and 1,051 Hispanic patents. Additional information was collected regarding age, sex, insurance status, and injury severity.

Descriptive statistics demonstrated that minority patients were younger, less likely t have insurance, and more likely to utilize public hospital facilities compared to non-Hispanic whites. The two groups, however, were similar in sex, method of injury, and injury severity.

The researchers found no significant differences in intensity of emergency department assessment, monitoring, treatment, or release from emergency departments between non-Hispanic whites and Hispanic and African American patients. Regional disparities, hospital ownership, and patient insurance status also failed to significantly affect the level of care.

"The obvious implication of the lack of ethnic disparities in emergency department management is that other causes of ethnic disparities in functional outcomes of trauma patients should be sought. These may include quality of inpatient care, use of high-cost medications and procedures, access to acute and long-term rehabilitation services and follow-up after discharge from acute care hospitalization," conclude Shafi and Gentilello. "It is also entirely possible that the disparities in outcomes have little to do with quality of medical care received."

The researchers add: "Other factors, such as the socioeconomic status, educational level, employment and insurance status, rural vs. urban location, language barriers and cultural and religious beliefs and practices, need to be studied further to understand differences between various ethnic groups."

Ethnic Disparities in Initial Management of Trauma Patients in a Nationwide Sample of Emergency Department Visits
Shahid Shafi, MD, MPH; Larry M. Gentilello, MD
Archives of Surgery (2008). 143[11]: pp. 1057 - 1061.
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Written by: Peter M Crosta
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