Images in Black and White: Disparities in Utilization of Computed Tomography and Ultrasound for Older Adults with Abdominal Pain
Introduction: Abdominal pain is the leading emergency department (ED) chief complaint in older (≥65 years of age) adults, accounting for 1.4 million ED visits annually. Ultrasound and computed tomography (CT) are high-yield tests that offer rapid and accurate diagnosis for the most clinically signif...
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| Format: | Article |
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eScholarship Publishing, University of California
2025-02-01
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| Series: | Western Journal of Emergency Medicine |
| Online Access: | https://escholarship.org/uc/item/5r65r0cm |
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| author | Ijeoma C. Unachukwu Michael N. Adjei-Poku Olivia C. Sailors Rachel Gonzales Eugenia South Zach Meisel Rachel R. Kelz Anne R. Cappola Ari B. Friedman |
| author_facet | Ijeoma C. Unachukwu Michael N. Adjei-Poku Olivia C. Sailors Rachel Gonzales Eugenia South Zach Meisel Rachel R. Kelz Anne R. Cappola Ari B. Friedman |
| author_sort | Ijeoma C. Unachukwu |
| collection | DOAJ |
| description | Introduction: Abdominal pain is the leading emergency department (ED) chief complaint in older (≥65 years of age) adults, accounting for 1.4 million ED visits annually. Ultrasound and computed tomography (CT) are high-yield tests that offer rapid and accurate diagnosis for the most clinically significant causes of abdominal pain. In this study we used nationally representative data to examine racial/ethnic differences in cross-sectional imaging for older adults presenting to the ED with abdominal pain. Methods: We performed a retrospective, cross-sectional analysis using data from the National Hospital Ambulatory Medical Care Survey (NHAMCS) to assess differences in the rate of imaging between White and Black older adults presenting to the ED for abdominal pain. Our primary outcome was the receipt of abdominal CT and/or ultrasound imaging. Results: Across 1,656 older adult ED visits for abdominal pain, White patients were 26.8% (relatively, 14.2% absolute) more likely to receive abdominal CT and/or ultrasound than Black patients: 802 of 1,197 (67.0%) White patients were 26.8% (relatively, 14.2% absolute) more likely to receive abdominal computed tomography and/ or ultrasound than Black patients (P=0.01). Conclusion: This study revealed that Black older adults presenting to the ED with abdominal pain receive significantly lower levels of cross-sectional imaging (CT/ultrasound) than White patients. Our findings highlight the need for further investigations into causes of disparities while initiating quality improvement processes to assess and address site- and clinician-specific patterns of care. |
| format | Article |
| id | doaj-art-a2983a55cff7466cad7c3eae1e08e86c |
| institution | Kabale University |
| issn | 1936-900X 1936-9018 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | eScholarship Publishing, University of California |
| record_format | Article |
| series | Western Journal of Emergency Medicine |
| spelling | doaj-art-a2983a55cff7466cad7c3eae1e08e86c2025-08-20T03:27:18ZengeScholarship Publishing, University of CaliforniaWestern Journal of Emergency Medicine1936-900X1936-90182025-02-0126345245710.5811/westjem.18087wjem-26-452Images in Black and White: Disparities in Utilization of Computed Tomography and Ultrasound for Older Adults with Abdominal PainIjeoma C. Unachukwu0Michael N. Adjei-Poku1Olivia C. Sailors2Rachel Gonzales3Eugenia South4Zach Meisel5Rachel R. Kelz6Anne R. Cappola7Ari B. Friedman8University of Pennsylvania, Department of Emergency Medicine, Philadelphia, PennsylvaniaUniversity of Pennsylvania, Department of Emergency Medicine, Philadelphia, PennsylvaniaUniversity of Pennsylvania, Department of Emergency Medicine, Philadelphia, PennsylvaniaUniversity of Pennsylvania, Department of Emergency Medicine, Philadelphia, PennsylvaniaUniversity of Pennsylvania, Department of Emergency Medicine, Philadelphia, PennsylvaniaUniversity of Pennsylvania, Department of Emergency Medicine, Philadelphia, PennsylvaniaUniversity of Pennsylvania, Leonard Davis Institute of Health Economics, Philadelphia, PennsylvaniaUniversity of Pennsylvania, Department of Endocrinology, Philadelphia, PennsylvaniaUniversity of Pennsylvania, Department of Emergency Medicine, Philadelphia, PennsylvaniaIntroduction: Abdominal pain is the leading emergency department (ED) chief complaint in older (≥65 years of age) adults, accounting for 1.4 million ED visits annually. Ultrasound and computed tomography (CT) are high-yield tests that offer rapid and accurate diagnosis for the most clinically significant causes of abdominal pain. In this study we used nationally representative data to examine racial/ethnic differences in cross-sectional imaging for older adults presenting to the ED with abdominal pain. Methods: We performed a retrospective, cross-sectional analysis using data from the National Hospital Ambulatory Medical Care Survey (NHAMCS) to assess differences in the rate of imaging between White and Black older adults presenting to the ED for abdominal pain. Our primary outcome was the receipt of abdominal CT and/or ultrasound imaging. Results: Across 1,656 older adult ED visits for abdominal pain, White patients were 26.8% (relatively, 14.2% absolute) more likely to receive abdominal CT and/or ultrasound than Black patients: 802 of 1,197 (67.0%) White patients were 26.8% (relatively, 14.2% absolute) more likely to receive abdominal computed tomography and/ or ultrasound than Black patients (P=0.01). Conclusion: This study revealed that Black older adults presenting to the ED with abdominal pain receive significantly lower levels of cross-sectional imaging (CT/ultrasound) than White patients. Our findings highlight the need for further investigations into causes of disparities while initiating quality improvement processes to assess and address site- and clinician-specific patterns of care.https://escholarship.org/uc/item/5r65r0cm |
| spellingShingle | Ijeoma C. Unachukwu Michael N. Adjei-Poku Olivia C. Sailors Rachel Gonzales Eugenia South Zach Meisel Rachel R. Kelz Anne R. Cappola Ari B. Friedman Images in Black and White: Disparities in Utilization of Computed Tomography and Ultrasound for Older Adults with Abdominal Pain Western Journal of Emergency Medicine |
| title | Images in Black and White: Disparities in Utilization of Computed Tomography and Ultrasound for Older Adults with Abdominal Pain |
| title_full | Images in Black and White: Disparities in Utilization of Computed Tomography and Ultrasound for Older Adults with Abdominal Pain |
| title_fullStr | Images in Black and White: Disparities in Utilization of Computed Tomography and Ultrasound for Older Adults with Abdominal Pain |
| title_full_unstemmed | Images in Black and White: Disparities in Utilization of Computed Tomography and Ultrasound for Older Adults with Abdominal Pain |
| title_short | Images in Black and White: Disparities in Utilization of Computed Tomography and Ultrasound for Older Adults with Abdominal Pain |
| title_sort | images in black and white disparities in utilization of computed tomography and ultrasound for older adults with abdominal pain |
| url | https://escholarship.org/uc/item/5r65r0cm |
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