Abstract P220: Disparity In Hospital Admissions And Length Of Stay Based On Income Status For Emergency Department Hypertensive Crisis Visits: A Cross-sectional Study Using The Nationwide Emergency Department Sample
Introduction: Racial, gender and lower socioeconomic status have been shown to negatively impact the delivery of care. How this impacts the management of hypertensive crisis (HC) remains unclear. Objective: Identify disparities on admission frequency and length of stay (LOS) among those presenting with HC, as a function of household income. Methods: This is a cross-sectional analysis of 2016 ED visits and supplemental Inpatient data from the Nationwide Emergency Department Sample. Median household income quartiles were established. A multivariable logistic regression model was used to estimate odds of admission in each income quartile. A multivariable linear regression model was used to predict LOS. Results: After applying sample weighting, the total number of ED visits was 33,728 with 25442, 6906, and 1380 visits for hypertensive urgency (HU), emergency (HE) and unspecified crisis, respectively. There were 13191, 8889, 6401, 5247 visits in the (1 st ) lowest, 2 nd , 3 rd and 4 th (highest) income quartiles, respectively. The median age was 61 and 58 years for HU and HE, respectively. The most common comorbidity was chronic kidney disease. Individuals with the highest income, had a lower odds of admission compared to the lowest quartile [Adjusted Odds Ratio: 0.41, 95% CI: 0.22,0.74] ( Figure 1a ). There was a significant linear association between income quartile and LOS across all HC and HE [beta coefficient: 0.411, 0.407 p value = 0.015, 0.019] ( Figure 1b ). Conclusions: In this study, patients with lower income were more likely to be admitted, while those with higher income exhibited a longer LOS. Clinicians must be made aware these disparities to ensure the equitable delivery of care.