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Black, Hispanic Kids Are Less Likely Than White Kids To Receive Diagnostic Imaging During ER Visit

David Goldman
In this Feb. 9, 2018, file photo, a radiology technician looks at a chest X-ray of a child suffering from flu symptoms at Upson Regional Medical Center in Thomaston, Ga.

Black and Hispanic children are less likely to receive diagnostic imaging during an emergency room visit compared to white children, according to a new study from UPMC and University of Pittsburgh researchers.

The research, which was published online Friday in the journal “JAMA Open Network,” includes data from more than 6 million children and adolescents who went to one of 44 pediatric hospitals from 2016 to 2019 for emergency medical care.

Data analysis found that Black children were 18% less likely than white children to receive diagnostic imaging during an ER visit. Hispanic children were 13% less likely to have imaging, compared to whites.

“We know from other studies that physicians do exhibit a preference for white patients,” said Dr. Jennifer Marin, the study’s lead author. “To that end, I think that affects our decision making when it comes to diagnostic imaging.”

Researchers found that this disparity persisted even after they corrected for a host of factors—including a patient’s diagnosis, household income, or type of insurance coverage.

“Even if they were on public insurance, white children were still more likely [to receive imaging] than Black children. Private insurance, white children were still more likely than non-white children,” said Marin, who is an associate professor of pediatrics, emergency medicine and radiology at Pitt’s School of Medicine.

In addition to implicit racial bias, Marin said that parental preference might also be a contributing factor.

“Preference does play a role in tests,” she said. “When we talk about low-value care, and potentially unnecessary care, there's definitely literature to support that white patients are more likely to receive that care.”

The study did not look at how differences in care affect patient outcomes; Marin said that might be an area of future study.

Marin said she’d also like to see research on how the racial disparity the study documented can be corrected, and she hopes the study’s findings will prompt both individual physicians and entire emergency departments to examine how their practices differ based on a patient’s race.

Sarah Boden covers health and science for 90.5 WESA. Before coming to Pittsburgh in November 2017, she was a reporter for Iowa Public Radio where she covered a range of issues, including the 2016 Iowa Caucuses.
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