ER chest pain tests driven by race, gender, insurance

From the Asbury Park Press:

Race, gender and health insurance status strongly influence how U.S. hospital emergency departments evaluate patients with chest pain, says a new study.

Researchers at the Medical College of Wisconsin and Johns Hopkins University analyzed data on 7,068 patients, 30 years or older, who had chest pain and went to an emergency department from 1995 to 2000.

Overall, black males were 25 percent to 30 percent less likely than non-black men to receive any diagnostic or monitoring tests, such as electrocardiography, chest radiography, oxygen saturation monitoring and cardiac monitoring.

Over the six-year study period, there was a decrease in the use of all forms of diagnostic testing and monitoring (with the exception of oxygen saturation monitoring) among black men. From 1995 to 2000, the use of electrocardiography decreased more than 16 percent among black men, while the use of cardiac monitoring declined 26 percent.

The study also found that black women were about 5 percent less likely to have electrocardiography than non-black males, and 17 percent less likely to have cardiac monitoring, 14 percent less likely to have oxygen saturation monitoring, and 6 percent less likely to have chest radiography. Non-black women were also less likely than non-black men to have these
tests.

Insurance was another important factor. Compared to patients with commercial insurance, those with other types of insurance were 13 percent less likely to have electrocardiography, 21 percent less likely to have cardiac monitoring, 23 percent less likely to have oxygen saturation monitoring, and more than 13 percent less likely to have chest radiography.