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Images in Black and White: Disparities in Utilization of Computed Tomography and Ultrasound for Older Adults with Abdominal Pain

Title: Images in Black and White: Disparities in Utilization of Computed Tomography and Ultrasound for Older Adults with Abdominal Pain
Authors: Unachukwu, Ijeoma; Adjei-Poku, Michael N.; Sailors, Olivia C.; Gonzales, Rachel; South, Eugenia; Meisel, Zach; Kelz, Rachel R.; Cappola, Anne R.; Friedman, Ari B.
Source: Western Journal of Emergency Medicine: Integrating Emergency Care with Population Health, vol 26, iss 3
Publisher Information: eScholarship, University of California
Publication Year: 2025
Collection: University of California: eScholarship
Subject Terms: abdominal pain; CT; ultrasound; geriatric; racial disparities; imaging
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.
Document Type: article in journal/newspaper
File Description: application/pdf
Language: unknown
Relation: qt5r65r0cm; https://escholarship.org/uc/item/5r65r0cm; https://escholarship.org/content/qt5r65r0cm/qt5r65r0cm.pdf
DOI: 10.5811/westjem.18087
Availability: https://escholarship.org/uc/item/5r65r0cm; https://escholarship.org/content/qt5r65r0cm/qt5r65r0cm.pdf; https://doi.org/10.5811/westjem.18087
Rights: CC-BY
Accession Number: edsbas.B74081B8
Database: BASE