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Area of Science:

  • Health Services Research
  • Health Equity
  • Patient Transfer Studies

Background:

  • Interfacility transfers from emergency departments (EDs) significantly impact patient care and experience.
  • Insurance status is a critical factor influencing patient disposition and access to care.
  • Disparities in healthcare access for minority populations require thorough investigation.

Purpose of the Study:

  • To determine if interfacility transfers for non-contracted insurance status disproportionately affect minority patients in an academic ED.
  • To quantify the impact of insurance incompatibility on transfer rates across different socioeconomic minority groups.
  • To identify specific minority demographics most affected by insurance-driven transfers.

Main Methods:

  • Retrieved data from the hospital's electronic health record system for interfacility transfers.
  • Reviewed patient records to identify transfers specifically due to insurance contracting status.
  • Compared transfer rates for insurance incompatibility among Hispanic, Hispanic non-White, Black, Native American, and non-English speaking patient groups versus others.

Main Results:

  • Of 735 eligible transfers, 49.7% were due to insurance incompatibility.
  • All queried minority demographics showed increased transfer rates for insurance incompatibility.
  • Non-English speakers (2.06%) and Hispanic patients (1.31%) experienced the most severe disparities compared to English speakers (0.90%) and non-Hispanic whites (0.87%).

Conclusions:

  • Minority populations, including non-English speakers and Hispanic patients, are disproportionately affected by interfacility transfers for non-contracted insurance status.
  • Insurance incompatibility represents a significant driver of disparate transfer rates in academic emergency departments.
  • Addressing insurance-related transfer disparities is crucial for improving health equity and patient experience.