Disparities in emergency department use for ambulatory care sensitive conditions in chicago

Previous research has demonstrated disparities in Emergency Department (ED) use and subsequent hospitalizations by gender, race/ethnicity, and socioeconomic status. These disparities may represent differential access to or quality of care among underserved populations. The Prevention Quality Indicators (PQI) may be used to investigate ED visits for potentially preventable conditions, labeled Ambulatory Care Sensitive Conditions (ACSC). In order to investigate disparities of care in Chicago, we analyzed the rate of ACSC ED visits and subsequent hospitalizations at the city and zip code level. ACSC rates were calculated by gender and race/ethnicity at the city level and correlated with racial and socioeconomic factors at the zip code level.

Overall, ACSC visits accounted for 10.6% of the total ED visits from 2009-2010. Females were 1.3 times more likely to have an ACSC ED visit, but not more likely to be hospitalized. Non-Hispanic-Blacks (NHB) were 3.4 times more likely to have an ACSC ED visits than Non-Hispanic Whites (NHW), and 2.1 times more likely to be hospitalized. Hispanics were 1.7 times more likely to have an ACSC ED visit than NHW, and 1.3 times more likely to be hospitalized. At the zip code level, the ACSC ED visit rate was strongly negatively correlated with %NHW (r=-0.81, p<0.001) and median household income (-0.68, p<0.001) and positively correlated with %NHB (r=0.72, p<0.001). Understanding these disparities in ED use and subsequent hospitalizations for preventable conditions may aide in creating targeted interventions to improve health care access and quality for underserved populations.