The purpose of this study was to investigate whether emergency department use varied by race or ethnicity among a group of poor, predominantly uninsured patients who used a public hospital emergency department, and whether differences in emergency department use were explained by differences in the prevalence of barriers to health care among different groups. Data were collected from a UCLA medical center over a two-week period in 1990.

Black patients were more likely than whites to have used the emergency department
two or more times in the past three months (19% of blacks versus 13.2% of whites; 11.3% of Hispanics). However several other factors were also related to having two or more visits to the emergency department (having Medicare or private insurance, having an affiliated clinic as the regular source of care; worse health; and having difficulty obtaining transportation). In multivariate analysis, these factors were shown to explain the race effect.

Thus, there are racial differences in emergency department use, and these differences are mediated by racial differences in several factors that are known to predict health care use. It will be important to determine if this pattern reflects substandard care for black patients.

The authors concluded that “the determinants of emergency department use at this public hospital are similar to the determinants of health care use in other settings. Racial and ethnic groups may have different perceived needs for medical care or preferences for where they receive their care, but these can only be examined and understood after consideration of known determinants for health care use.”