Racial and gender disparities in violent trauma: results from the NEMSIS database
Fecha
2018-04Autor
Bode, Alexander D.
Singh, Mallika
Andrews R., James
Báez, Amado Alejandro
Metadatos
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Barriers to EMS care can result in suboptimal outcomes and preventable morbidity and mortality.
Large EMS databases such as the National Emergency Medical Services Information System (NEMSIS) dataset
provide valuable data on the relative incidence of such barriers to care.
Methods: A retrospective cross-sectional analysis was performed using the NEMSIS database. Cases of violent
trauma were collected based on gender and racial group. Each group was analyzed for the ratio of cases that involved
anEMS barrier to care. Chi-square testingwas used to assess associations, and the relative riskwas used as
the measure of strength of association. For all tests, statistical significance was set at the 0.05 level.
Results: 719,812 cases of violent trauma were analyzed using the NEMSIS dataset. EMS encountered barriers to
care for white and non-white patientswas found to be 4.9% and 4.0% respectively. The difference between groups
was found to be 0.9% (95% CI [0.7%, 1.1%] p b 0.0001). RRwas 1.23 forwhite patients (95% CI [1.19, 1.26]), and 0.82
(95% CI [0.79, 0.84]) for non-white. EMS barriers to care for male and female patients was found to be 6.03% and
3.34%, respectively. The difference between groups was found to be 2.7% (95% CI [2.6%, 2.8%] p b 0.0001). RR for
male patients was 1.80 (95% Cl [1.76, 1.84]) while RR for female patients was 0.55 (95% CI [0.54, 0.57]).
Conclusions: Racially white patients and male patients have a statistically significant higher risk of encountering
an EMS barrier to care in cases of violent trauma.
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