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Objectives <p>Systemic inequity continues to adversely impact older Black adults. Consequently, older Black adults are at high risk for hospitalizations at emergency departments (EDs).</p> Design <p>This cross-sectional study explored the sociodemographic, individual health, and interpersonal factors associated with ED utilization among older Black adults with chronic illness. Participants (<i>n</i> = 301) completed surveys exploring sociodemographic (i.e., gender identity, educational attainment, socioeconomic status, marital status, employment status, insurance status, Medicaid eligibility), individual health (i.e., stress, depressive symptoms), and interpersonal (i.e., perceived interpersonal control, perceived racism, trust in physician, patient satisfaction, perceived cultural sensitivity) factors related to healthcare utilization. Multivariable logistic regression, using the backward selection approach, was used.</p> Results <p>Higher patient satisfaction with providers’ communication (OR = 2.25, 95% CI = 1.15–4.58, <i>p</i> = 0.017) and higher levels of depressive symptoms (OR = 1.09, 95% CI = 1.01–1.17, <i>p</i> = 0.027) were associated with greater odds of an ED visit in the past year. Higher perceived provider racism (OR = 0.94, 95% CI = 0.90–0.97, <i>p</i> &lt; 0.001) was associated with lower odds of an ED visit in the past year.</p> Conclusion <p>Increased likelihood of ED utilization in the past year is associated with higher depressive symptoms, higher patient satisfaction with patient-provider communication, and lower perceived racism in healthcare settings. These results highlight the importance of the patient-provider relationship and the need for increased management and support of co-occurring physical and mental health concerns among older Black adults.</p>

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Factors Associated with Emergency Department Utilization among Older Black Adults with Chronic Illness in the United States

  • 期刊论文

  • 发表日期：

    2026年3月23日

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  • Kirsten Klein,
  • Carolyn M. Tucker,
  • Vivek Vemugunta,
  • Stephen Anton,
  • Ji-Hyun Lee,
  • Derek Li,
  • Marjorie Belcher,
  • Juanita Miles-Hamilton

摘要

Objectives

Systemic inequity continues to adversely impact older Black adults. Consequently, older Black adults are at high risk for hospitalizations at emergency departments (EDs).

Design

This cross-sectional study explored the sociodemographic, individual health, and interpersonal factors associated with ED utilization among older Black adults with chronic illness. Participants (n = 301) completed surveys exploring sociodemographic (i.e., gender identity, educational attainment, socioeconomic status, marital status, employment status, insurance status, Medicaid eligibility), individual health (i.e., stress, depressive symptoms), and interpersonal (i.e., perceived interpersonal control, perceived racism, trust in physician, patient satisfaction, perceived cultural sensitivity) factors related to healthcare utilization. Multivariable logistic regression, using the backward selection approach, was used.

Results

Higher patient satisfaction with providers’ communication (OR = 2.25, 95% CI = 1.15–4.58, p = 0.017) and higher levels of depressive symptoms (OR = 1.09, 95% CI = 1.01–1.17, p = 0.027) were associated with greater odds of an ED visit in the past year. Higher perceived provider racism (OR = 0.94, 95% CI = 0.90–0.97, p < 0.001) was associated with lower odds of an ED visit in the past year.

Conclusion

Increased likelihood of ED utilization in the past year is associated with higher depressive symptoms, higher patient satisfaction with patient-provider communication, and lower perceived racism in healthcare settings. These results highlight the importance of the patient-provider relationship and the need for increased management and support of co-occurring physical and mental health concerns among older Black adults.