Diagnostic testing disparities identified between Black and White patients

September 5, 2024

Black patients are less likely than White patients with a nonspecific diagnosis of interest to receive related diagnostic testing in the emergency department (ED), potentially resulting in an increased risk of missed diagnoses. Future studies should focus on uncovering the root causes of diagnostic differences among racial and ethnic groups and examine how these disparities might be linked to missed diagnoses.

The study

• Researchers used a previously validated diagnostic intensity index to evaluate differences in diagnostic testing rates by race and ethnicity in the acute care setting to infer test overuse. The study included ED discharges, hospital observation stays, and hospital admissions among EDs and acute care hospitals in Kentucky, Maryland, North Carolina, and New Jersey, from 2016 through 2018.
• To estimate rates of nondiagnostic testing, nonspecific principal discharge diagnoses (nausea and vomiting, abdominal pain, chest pain, and syncope) were paired with related diagnostic tests.

Key findings

• Most of the 3,683,055 encounters were ED discharges (80.6%; 28.7% for Black, 8.2% for Hispanic, and 58.1% for White patients).
• Compared with White patients, Black patients discharged from the ED with a diagnosis of interest had an adjusted odds ratio of 0.74 (95% CI, 0.72-0.75) for having related diagnostic testing. No other racial or ethnic disparities of a similar magnitude were observed in any acute care settings.

Source:

Ellenbogen MI, et al. (2024, August 1). JAMA Netw Open. Race and Ethnicity and Diagnostic Testing for Common Conditions in the Acute Care Setting. https://pubmed.ncbi.nlm.nih.gov/39190305/