![]() But at what point is the extra loss of time it takes to get there worthwhile or not worthwhile? We need more research to understand the role that patient choice, usual source of care, and clinical condition play in guiding EMS transportation decisions in diverse systems across the United States.” ![]() “What are the potential issues with patients not being brought to the nearest place? Let’s say they go to the medical center where their doctors, their patient records are-we know that continuity of care is important. “This study raises interesting questions,” Hanchate says. Hanchate hopes that this study may change that, and that EMS providers may document whether a patient requests to be brought to a specific medical center. James FeldmanĮMS currently doesn’t keep track of the details that determine which hospital a patient is brought to. This research is a necessary first step in order to examine the effects ambulance diversion has on patient care and understanding the relationship between emergency utilization and healthcare disparities. “It could be a benign phenomenon where people are being brought to the place that they’ve asked to go, because that’s where their regular doctor or cardiologist is located.” “This is not a causal study, so we really don’t know why we are seeing this pattern,” says study corresponding author Amresh Hanchate, a MED associate professor of medicine and a health economist at VA Boston Healthcare System. The study also found that black and Hispanic patients were more likely to be transported to a “safety net” hospital-a type of medical center that by legal obligation or mission provides healthcare for individuals regardless of their insurance status-compared to their white counterparts living in the same zip code. The widest disparities were seen in larger urban areas with multiple hospitals and emergency departments within the vicinity. The results of the study showed sizable differences by race and ethnicity in which medical centers patients were brought to by EMS. The study also looked at how often black and Hispanic patients were transported to the destinations most frequently used for white patients. Using national Medicare claims data, the study divided patients based on the zip code they lived in, and compared which emergency departments and hospitals non-Hispanic white, black, and Hispanic patients were brought to within the same zip code. According to the researchers, these findings, published online in JAMA Network, suggest that the difference in these transportation destinations may be motivated by factors other than proximity or time. They also found that 40 percent of patients overall, regardless of race, were not taken to the nearest hospital. In a first-of-its-kind study, researchers at the Boston University School of Medicine showed large differences between the EMS-transport destinations of black and Hispanic patients in comparison with their white counterparts. Until now, there has been scant research on the destination patterns of EMS-transported patients to hospitals. But to what extent this occurs and whether this varies based on the race or ethnicity of patients has remained unknown. National guidelines require EMS to transport patients to the nearest suitable hospital. Your race-not which hospital is nearest-may influence which emergency room you are transported to by emergency medical services (EMS).
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