Disparities in Access to Endoscopy for Patients With Upper Gastrointestinal Bleeding Presenting to Emergency Departments

Abstract

In the United States, upper gastrointestinal bleeding (UGIB) accounts for approximately 311,000 admissions yearly.1 The standard of care in most patients hospitalized with acute UGIB is evaluation with esophagogastroduodenoscopy (EGD).2 For Black and Hispanic populations, access to endoscopic evaluation when presenting to the emergency department (ED) with a primary diagnosis of acute UGIB has not been clearly described. A previous study using a nationwide all-payer database found that among hospitalized patients with nonvariceal UGIB, uninsured and Black patients have lower odds of undergoing EGD, Black and Hispanic patients have lower odds of early endoscopic evaluation (<24 hours), and Native American patients have the highest odds of in-hospital mortality.