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Titolo:
Effect of ethnicity on denial of authorization for emergency department care by managed care gatekeepers
Autore:
Lowe, RA; Chhaya, S; Nasci, K; Gavin, LJ; Shaw, K; Zwanger, ML; Zeccardi, JA; Dalsey, WC; Abbuhl, SB; Feldman, H; Berlin, JA;
Indirizzi:
Univ Penn, Med Ctr, Dept Biostat & Epidemiol, Philadelphia, PA 19104 USA Univ Penn Philadelphia PA USA 19104 Epidemiol, Philadelphia, PA 19104 USA Univ Penn, Med Ctr, Dept Emergency Med, Philadelphia, PA 19104 USA Univ Penn Philadelphia PA USA 19104 gency Med, Philadelphia, PA 19104 USA Univ Penn, Med Ctr, Leonard Davis Inst Hlth Econ, Philadelphia, PA 19104 USA Univ Penn Philadelphia PA USA 19104 Hlth Econ, Philadelphia, PA 19104 USA Univ Penn, Med Ctr, Dept Internal Med, Philadelphia, PA 19104 USA Univ Penn Philadelphia PA USA 19104 ernal Med, Philadelphia, PA 19104 USA Philadelphia Emergency Med Res Consortium, Philadelphia, PA USA Philadelphia Emergency Med Res Consortium Philadelphia PA USA ia, PA USA Univ Penn, Med Ctr, Ctr Clin Epidemiol & Biostat, Philadelphia, PA 19104 USA Univ Penn Philadelphia PA USA 19104 & Biostat, Philadelphia, PA 19104 USA
Titolo Testata:
ACADEMIC EMERGENCY MEDICINE
fascicolo: 3, volume: 8, anno: 2001,
pagine: 259 - 266
SICI:
1069-6563(200103)8:3<259:EOEODO>2.0.ZU;2-U
Fonte:
ISI
Lingua:
ENG
Soggetto:
RACE; SURGERY; IMPACT; COSTS; SEX;
Keywords:
health maintenance organizations; health services accessibility; attitude of health personnel; emergency medicine; race; ethnicity; African Americans; whites;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
35
Recensione:
Indirizzi per estratti:
Indirizzo: Lowe, RA Univ Penn, Med Ctr, Ctr Clin Epidemiol & Biostat, 914 Blockley Hall,423 Guardian Dr, Philadelphia, PA 19104 USA Univ Penn 914 Blockley Hall,423 Guardian Dr Philadelphia PA USA 19104
Citazione:
R.A. Lowe et al., "Effect of ethnicity on denial of authorization for emergency department care by managed care gatekeepers", ACAD EM MED, 8(3), 2001, pp. 259-266

Abstract

Objective: After a pilot study suggested that African American patients enrolled in managed care organizations (MCOs) were more likely than whites tobe denied authorization for emergency department (ED) care through gatekeeping, the authors sought to determine the association between ethnicity anddenial of authorization in a second, larger study at another hospital. Methods: A retrospective cohort design was used, with adjustment for triage score, age, gender, day and time of arrival at the ED, and type of MCO. Results: African Americans were more likely to be denied authorization for ED visits by the gatekeepers representing their MCOs even after adjusting for confounders, with an odds ratio of 1.52 (95% CI = 1.18 to 1.94). Conclusions:African Americans were more likely than whites to be denied authorization for ED visits. The observational study design raises the possibility that incomplete control of confounding contributed to or accounted for the association between ethnicity and gatekeeping decisions. Nevertheless, the questions that these findings raise about equity of gatekeeping indicate a need for additional research in this area.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 22/01/20 alle ore 06:27:56