Is access to primary healthcare the solution we have been searching for regarding emergency department utilization differences between minority and non-minority patients?

This study examines differences in emergency department (ED) utilization between minority and non-minority patients within a free clinic and the additional factors that contribute to minority patients' utilization. A total of 971 surveys collected from the Champaign County Christian Health Center (CCCHC) were analyzed to determine demographic characteristics and healthcare utilization of the study population. Univariate statistical analysis was utilized to investigate demographic characteristics of the study population, such as race/ethnicity, age and income. A chi-square analysis evaluated differences between racial/ethnic groups' ED utilization outcomes (i.e., number of ED visits, reason for ED visit), and location visited for healthcare outside of the ED. Bivariate statistical analysis (ANOVA) was utilized to compare means across groups for income, number of ED visits, and number of individuals within a household. The Generalized Linear Model was applied to compare means across multiple independent groups for race/ethnicity and female head of household. African American patients had higher mean number of visits to the ED than Caucasian patients (1.41 and 1.04, respectively). A higher percentage of African American patients (16.4%) than Caucasian patients (14.4%) reported they would have sought treatment in the ED for healthcare in the absence of CCCHC. Across all racial/ethnic groups, the majority of all visits to the ED were for non-urgent care. Alternative sources of healthcare and income were also assessed. Caucasian patients reported a higher percentage of visits to the hospital for care than African American patients (12.8% and 11.4%, respectively); Caucasian patients earned a higher annual income ($11,005.58) than minority patients (African American: $8,050.00; Hispanic: $10,044.55; “Other”: $9,977.47). These results supported our hypothesis that minority patients were more likely to receive healthcare from EDs, and Caucasian patients were more likely to receive healthcare from primary healthcare facilities. Results also indicate that while minority patients earned lower incomes and frequented EDs in greater numbers, they incurred a higher cost of care. African American patients also yielded the highest mean number of ED visits within a female-headed household (M = 1.57). These findings suggest that the existence of the CCCHC free health center helped to offset the influx of minority patients into EDs, where they would have incurred higher costs of care while earning lower incomes. These findings also imply that ensuring greater access to primary healthcare clinics, such as CCCHC, for minorities would help eliminate the disparity in ED utilization between Caucasian and minority patients.