Abstract
We propose and empirically implement a test for the presence of racial prejudice among emergency department (ED) physicians based on the bounceback rates of the patients who were discharged after receiving diagnostic tests during their initial ED visits. A bounceback is defined as a return to the ED within 72 hours of being initially discharged. Based on a plausible model of physician behavior, we show that differential bounceback rates across patients of different racial groups who are discharged after receiving diagnostic tests from their ED visits are informative of the racial prejudice of the physicians. Applying the test to administrative data of ED visits from California and New Jersey, we do not find evidence of prejudice against black and Hispanic patients. Our finding suggests that, at least in the emergency department setting, taste based discrimination does not play an important role in the racial disparities in health care.
Highlights
The presence and pervasiveness of racial disparities in health care and health outcomes have been abundantly documented.1 It is conceptually useful to broadly group the various potential channels for racial disparities in health outcomes into three categories
At least in the emergency department setting, taste based discrimination does not play an important role in the racial disparities in health care
The sample used in these regressions is the set of patients who were discharged from the initial Emergency Department (ED) visits with at least one diagnostic test
Summary
The presence and pervasiveness of racial disparities in health care and health outcomes have been abundantly documented. It is conceptually useful to broadly group the various potential channels for racial disparities in health outcomes into three categories. Patients of different races may contract various illnesses at different rates Such differences may result from different exposures to environmental hazards, different life style choices, and different genetic dispositions toward illnesses. This category of mechanisms will lead to racial disparities in health prior to the interactions between patients and the health care system. Patients of different races may have differential access to health care facilities and physicians. Patients of different races may receive differential quality of care even if they have access to the same health care facility and physicians.. This paper contributes to the literature on understanding the roles of statistical discrimination and racial prejudice by the health providers in explaining the racial disparities in health outcomes, in the context of emergency care
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