Disparities in Emergency Department Visits Among Collocated Racial/Ethnic Medicare Enrollees.

Area of Science:

• Health Services Research
• Health Disparities
• Gerontology

Background:

• Medicare fee-for-service beneficiaries represent a significant population for studying healthcare access.
• Understanding emergency department (ED) utilization patterns is crucial for resource allocation and healthcare policy.
• Racial and ethnic disparities in healthcare access and outcomes are well-documented but require granular analysis.

Purpose of the Study:

• To estimate differences in emergency department (ED) use among Medicare enrollees of different racial/ethnic groups residing in the same zip codes.
• To investigate whether racial/ethnic disparities in ED use persist across diverse socioeconomic and demographic subgroups.

Main Methods:

• Retrospective cohort study of Medicare fee-for-service beneficiaries aged 66+ (2006-2012).
• Stratified analysis by zip code racial/ethnic diversity (including Hispanic, Black, White enrollees).
• Comparison of ED visit rates, controlling for comorbidities, primary-care-treatable status, and socioeconomic factors (zip code poverty rate).

Main Results:

• 41% of zip codes met diversity criteria, encompassing 85% of beneficiaries.
• Higher ED visit rates were observed for Black (1.34 ratio) and Hispanic (1.23 ratio) enrollees compared to White enrollees.
• These disparities were consistent across all examined subgroups, including age, comorbidity, poverty rate, and urban/rural status.

Conclusions:

• Black and Hispanic Medicare enrollees exhibit higher rates of emergency department utilization than White enrollees.
• These disparities in ED use are evident both overall and within specific demographic and socioeconomic strata.
• Findings highlight persistent inequities in healthcare access and utilization within the Medicare population.