Insurance Group Research Articles

Outcomes after clipping and endovascular coiling for aneurysmal subarachnoid hemorrhage among dual-eligible beneficiaries

Dual-eligible beneficiaries, individuals with both Medicare and Medicaid coverage, represent a high-cost and vulnerable population; however, literature regarding outcomes is sparse. We characterized outcomes in dual-eligible beneficiaries treated for aneurysmal subarachnoid hemorrhage (aSAH) compared to Medicare only, Medicaid only, private insurance, and self-pay.A 10-year cross-sectional study of the National Inpatient Sample was conducted. Adult aSAH emergency admissions treated by neurosurgical clipping or endovascular coiling were included. Multivariable regression was used to adjust for confounders. A total of 57,666 patients met inclusion criteria. Dual-eligibles comprised 2.8% of admissions and were on average younger (62.4 years) than Medicare (70.0 years), older than all other groups, and had higher mean National Inpatient Sample-Subarachnoid Hemorrhage Severity Scores than all other groups (p ≤ 0.001). Among patients treated by clipping, dual-eligibles were less often discharged to home compared to Medicare (adjusted odds ratio (aOR) = 0.51, 95% CI = 0.30–0.87, p < 0.05) and all other insurance groups, p < 0.01. Likewise, those who received coiling were less often discharged to home compared to Medicaid (aOR = 0.41, 95% CI = 0.23–0.73), private (aOR = 0.42, 95% CI = 0.23–0.76) and self-pay patients (aOR = 0.24, 95% CI = 0.12–0.46). They also had increased odds of poor National Inpatient Sample-Subarachnoid Hemorrhage Outcome Measures compared to Medicaid, private, and self-pay patients, all p < 0.05. There were no differences in inpatient mortality or total complications.In conclusion, dual-eligible patients had higher aSAH severity scores, less often discharged home, and among patients who received coiling, dual-eligibles had increased odds of poor outcome. Dual-eligible patients with aSAH represent a vulnerable population that may benefit from targeted clinical and public policy initiatives.

Disparity in telehealth and emergency department use among Medicaid and commercially insured patients receiving systemic therapy for cancer in Washington State following the COVID-19 Pandemic.

6546 Background: Washington was the first US state to experience the COVID-19 pandemic. Transmission risks and patient fears of visiting oncology practices during its onset resulted in rapid adoption of telehealth services. We hypothesized that the pandemic would widen disparities in oncology practice visits between Medicaid and commercially insured patients, resulting higher rates of emergency department (ED) visits during initial treatment. Methods: Linking Washington State SEER records with Medicaid and commercial insurance enrollment and claims records, we compared adults age &lt;65 with new solid tumor malignancies who received systemic treatment at academic and community oncology practices. Persons starting therapy March – June 2020 (COVID) were compared with those starting therapy March-June 2017-2019 (Pre-COVID). Poisson regressions were used to evaluate differences in oncology practice office visits and telehealth visits. Logistic regressions were used to evaluate the likelihood of at least one ED admission among patients starting systemic therapy pre- and post-COVID. Results: Among patients who met inclusion criteria (652 Commercial, 349 Medicaid), Medicaid enrollees had more advanced disease and more comorbidity versus commercial enrollees. In unadjusted analysis of E&amp;M and telehealth service visit codes, office-based visits fell for both insurance groups (Table) while telehealth service visits (negligible pre-COVID) were higher for commercial versus Medicaid enrollees post-COVID. The proportion of persons with ≥ 1 ED visit during therapy fell for both insurance groups. In Poisson models, Medicaid enrollees had significantly fewer total visits (P=0.001) and fewer telehealth visits (p&lt;0.001) compared commercial enrollees during the COVID period. In the logit models, ED visits trended lower for both groups after COVID (OR 0.53 95% CI 0.279 to 1.008). Among Medicaid enrollees, persons ages 40-49 and breast cancer patients were more likely to visit the ED. Among the commercially insured, persons with 2 or more comorbidities were more likely to visit the ED. The pre-post COVID change in likelihood of an ED visit was not significantly different between insurance groups (p=0.355). Conclusions: In Washington State, the COVID-19 pandemic created a substantial disparity in access to office-based and telehealth care for low-income patients receiving systemic therapy for new cancers. Reduced oncology practice visits among Medicaid patients did not widen existing disparities in utilization of emergency care.[Table: see text]

Post-acute conditions of patients with COVID-19 not requiring hospital admission

Post-acute conditions of patients with COVID-19 not requiring hospital admission

Determinants and performance of outsourcing in the european mutual fund market

Most studies on mutual fund outsourcing have focused on the U.S. market. The objective of our study is to investigate the determinants of the decision to outsource and the impact of outsourcing on fund performance in the European market. The European market differs from the U.S. one in terms of market structure. In the U.S., banks play a minor role while the situation in Europe is the opposite: Banks dominate the market, and independent companies play minor roles. This difference in market structure can impact both the decision to outsource and the relationship between outsourcing and fund performance. In the U.S., banks and insurance companies that do not specialize in portfolio management tend to outsource their portfolio management services to external management companies. In Europe, banking and insurance groups often have management companies integrated into their groups, allowing them to keep their portfolio management in-house. In terms of fund performance, in contrast to recent studies based on the U.S market, our results show that outsourced funds perform at least as well as in-housed funds. They are even more performing than in-house funds in the short term.

Post-operative Opioid, Benzodiazepine and Sedative Usage in Medicare versus Commercial Insurance Hand Surgery Patients.

Opioid usage has increased in recent years. The purpose of this study is to assess post-operative opioid, sedative, and benzodiazepine usage in a Medicare population. Consecutive patients undergoing elbow, wrist, and hand surgery by hand surgeons at one academic outpatient surgical center were prospectively enrolled. Patients were excluded if they were minors or if they underwent more than one surgical procedure during the study period. There were 269 patients enrolled, and this group was divided by insurance type into younger commercial insurance (CI) and older Medicare (MC) groups. The Pennsylvania Physician Drug Monitoring Program website was used to document all prescriptions of controlled substances filled six months prior to and after the surgical procedure. The mean age in the CI group was 45.8 years (range: 16-88) and 69.2 years (range: 43-91) in the MC group. Postoperatively, the CI patients filled significantly less opioid prescriptions than the MC group, 1.10 vs. 1.79. Patients in the CI group were given an average of 0.3 benzodiazepine prescriptions before surgery and 0.2 after surgery. Patients in the MC group were given 0.6 prescriptions before and 0.5 prescriptions of benzodiazepines after surgery. The CI group was given an average of 0.1 sedative/hypnotic prescriptions before surgery and 0.1 after surgery. The MC group was given 0.7 prescriptions before and 0.4 prescriptions of sedative/hypnotics after surgery.There were 0.17 prescriptions per patient in the CI group and 0.75 per patient in the MC group (P <.05). Twenty-two of 208 (10.6%) of CI and 16/61 (26.2%) of MC patients filled a prescription between 3-8 months post-operatively. Prolonged use of opioid, benzodiazepine and sedative medications is common after upper extremity surgical procedures. Older patients are also at risk, and may be even more likely than younger patients to use these medications post-operatively.

Ambulatory Care Sensitive Conditions Among All-Payer Claimants With Intellectual and Developmental Disabilities.

Inpatient hospitalizations for ambulatory care sensitive conditions (ACSC) among beneficiaries with and without intellectual and developmental disabilities (IDD) were examined using Medicaid and commercial claims from 2010-2014 in New Hampshire. IDD was defined with International Classification of Diseases, Ninth Edition, Clinical Modification (ICD-9-CM) codes using algorithms from the Centers for Medicare and Medicaid Services, and inpatient encounters were identified using the Healthcare Effectiveness Data and Information Set. In adjusted analyses, beneficiaries with IDD had more hospitalizations for ACSC than those without IDD in both insurance groups. Differences in patterns of ACSC prevalence, comorbidities, and hospital admissions between the commercially and Medicaid-insured groups show the value of using all-payer claims data, when possible, to understand health needs and health care utilization of insurance beneficiaries with IDD.

Hematopoietic Cell Transplantation Outcomes among Medicaid and Privately Insured Patients with Sickle Cell Disease

Compared with privately insured patients, recipients of Medicaid have been reported to have worse outcomes in several clinical conditions and following various surgical and medical procedures. However, the relationship between health insurance status and allogeneic hematopoietic cell transplantation (alloHCT) outcomes among patients with sickle cell disease (SCD) is not well described. We sought to compare alloHCT outcomes between patients with SCD who underwent alloHCT while enrolled on Medicaid versus those who underwent alloHCT while covered by private health insurance. We conducted a retrospective multicenter study using data reported to the Center for International Blood and Marrow Transplant Research. US patients enrolled on Medicaid or private insurance who underwent a first alloHCT for SCD between 2008 and 2018 were eligible for this study. The primary outcome was event-free survival (EFS), defined as time to death or graft failure. Secondary outcomes included overall survival (OS), graft failure, acute graft-versus-host disease (GVHD), and chronic GVHD. Univariate analysis was performed using the Kaplan-Meier method for EFS and OS. The proportion of patients with graft failure, acute GVHD, and/or chronic GVHD was calculated using the cumulative incidence estimator to accommodate competing risks (ie, death). Cox regression was used to identify factors associated with EFS, OS, graft failure, and acute and chronic GVHD. A total of 399 patients (Medicaid, n=225; private insurance, n=174) were included in this study. The median duration of follow-up was 34 months (range, 1.0 to 134.7 months) for the Medicaid group and 38.7 months (range, 0.3 to 139.3 months) for the private insurance group. Compared with the patients with private insurance, those on Medicaid had a significantly lower 3-year EFS (75.4% [95% confidence interval (CI), 69.4% to 81%] versus 82.2% [95% CI, 76.9% to 87.8%]; P=.0279) and a significantly higher 3-year cumulative incidence of graft failure (17.2% [95% CI, 12.5% to 22.5%] versus 10.5% [95% CI, 6.4% to 15.4%]; P=.0372). There were no significant between-group differences in 3-year OS (P=.6337) or in the cumulative incidence of acute GVHD (P=.4556) or chronic GVHD (P=.6878). Cox regression analysis after adjusting for other significant variables showed that the patients enrolled on Medicaid had a lower EFS (hazard ratio [HR], 2.36; 95% CI, 1.44 to 3.85; P=.0006) and a higher cumulative incidence of graft failure (HR, 2.57; 95% CI, 1.43 to 4.60; P=.0015), with no significant between-group differences in OS (HR, 0.99; 95% CI, 0.47 to 2.07; P=.9765), acute GVHD (HR, 0.94; 95% CI, 0.59 to 1.49; P=.7905), or cGVHD (HR, 0.98; 95% CI, 0.65 to 1.48; P=.9331). That EFS is worse in patients on Medicaid compared with privately insured individuals following alloHCT for SCD provides the rationale for research to better understand the mechanisms by which insurance status impacts alloHCT outcomes among patients with SCD.

Systemic-systematic risk in financial system: A dynamic ranking based on expectiles

We provide an international comparison of rankings for systematic and systemic risk in the financial system and examine whether both types of risk co-exist. The rankings are based on the information provided by a coherent downside risk measure, the expected shortfall (ES), which we compute from expectiles. Using rolling windows, we obtain dynamic rankings for different banks as well as for financial services and insurance firms from different international regions using principal components analysis (PCA). The main evidence for ES5% indicates that banks from Asia are the most systematic and insurance groups from Europe are the most systemic during a crisis period. Our results have implications for supervisors regarding the regulation of financial firms, as well as for investors regarding the incorporation of diversifiable and non-diversifiable risks in their portfolios.

Research on the readability of the chosen General Insurance Terms and Conditions on the Polish market

Readability and the study of complexity of functional texts are of interest to many contemporary researchers. Nowadays, in the age of miniaturization, simplification of our everyday life components, portability, and domination of short text forms in the mass media, we can observe a decrease in interest in reading larger texts or those containing specialized, difficult to understand vocabulary. This is how consumer contracts (including insurance contracts) are perceived. The purpose of this article is, therefore, to examine and evaluate the readability of the General Insurance Terms and Conditions (hereinafter referred as: Insurance GTC) — an integral part of the insurance contract. In order to determine whether the language of the Insurance GTC is easy to understand, precise and clear for consumers, a quantitative and qualitative analysis was carried out using readability formulas, in particular FOG-PL — fully adapted to the specificity of the Polish language. The Insurance GTC corpus from four different insurance groups was examined, and its level of language “fogginess” was compared with other utility texts.

Compared to commercially insured patients, Medicare advantage patients adopt newer diabetes drugs more slowly and adhere to them less.

ABSTRACTAimsTo compare rates of use and adherence for newer versus older second‐line diabetes drug classes in commercially insured, Medicare Advantage and dual‐eligible (covered by both Medicare and Medicaid) patients.Materials and MethodsLongitudinal cohort study using insurance claims data from 1/1/2012 to 12/31/2016 to identify patients with a first prescription, after metformin, of a second‐line diabetes drug (eg sulphonylurea, DPP‐4 inhibitor, thiazolidinedione, SGLT‐2 inhibitor or GLP‐1 receptor agonist) and to estimate their adherence to that drug class. Univariate analysis and multivariable logistic regression were used to examine the association between insurance type and use of each drug class, and between insurance type and adherence to each drug class.ResultsThe study population included 96,663 patients. Trends in drug use differed by insurance type. For example, sulphonylurea use declined among the commercially insured (from 46% to 39%, p < .001) but not among Medicare Advantage or dual‐eligible patients. Patterns of adherence also differed between insurance groups. For example, compared to commercial insurance, Medicare Advantage was associated with higher adherence to sulphonylurea (odds ratio [OR] 1.32, 95% CI 1.21–1.43)) but lower adherence to SGLT‐2 inhibitors (OR 0.43 (95% CI 0.33–0.56)).ConclusionsThis study finds differences in utilization and adherence for diabetes drugs across insurance types. Older medications such as sulphonylureas appear to be more used and better adhered to among Medicare Advantage recipients, while the opposite is true for newer medication classes. These findings suggest a need to personalize selection of diabetes drugs according to insurance status, particularly when adherence needs optimization.

Persons Acting for and on Behalf of a Policyholder ("Zośki")

The article examines the status, subject and principles of actions in respect of persons who act for and on behalf of the policyholder in group insurance as well as the remuneration and liability rules for such persons. Having emphasized that these persons are not insurance distributors, the author indicates how the provisions of the Insurance Distribution Act should be properly applied to them. In particular, his analysis aims at understanding the obligation to act in a reliable, fair and professional manner, in the best interests of the client. An important element of the analysis are the rules for remunerating persons acting on behalf of the policyholder in group insurance.

Prevalence of diabetes mellitus in the greater Bern region (Bern-Mittelland) 2010-2014.

Concerning diabetes mellitus, one of the greatest burdens in public health in the 21st century, epidemiological data in Switzerland are scarce. To address this issue, this study intended to use a little-known but convenient way to quantify the prevalence of diabetes mellitus in the Swiss region of Bern-Mittelland. In a population of approximately 330,000 people, the prevalence for the years 2010&ndash;2014 in adult persons was estimated using the capture-recapture method based on data collected routinely at the University Hospital in Bern (Inselspital) using outpatient lists and the registry of persons insured with Helsana Insurance Group. The estimated prevalence of diabetes mellitus was 3.97% (95% confidence interval [CI] 3.41&ndash;4.53%) in 2010, with a slight decrease to 3.65% (95% CI 3.24&ndash;4.06%) in 2014. An average of 3430 patients with diabetes or 26% of the total number appeared on at least one patient list. The remaining 74% were unknown patients identified by the capture-recapture method. The estimated prevalence of diabetes mellitus was in a range comparable to national and international studies. Thus, administratively collected data in clinics and insurance companies constitute a convenient data source for epidemiological studies. In conjunction with the capture-recapture method an approach with comparatively low effort and costs for the surveillance of chronic disease can be provided.

Response of Mexican life and non-life insurers to the low interest rate environment.

The purpose of this research is to examine whether insurers have improved their economic performance through efficiency as a reaction to the prolonged period of low interest rates. The results of an analysis of 22 years of data, using a two-stage data envelopment analysis approach (DEA), show that there is an inverse relationship between efficiency and interest rate. The non-life insurance group had a superior level of efficiency compared with that of the life insurance group. It seems that life insurance companies, to some extent, transferred their inefficiency to customers to maintain their solvency. Additionally, this research shows that companies with substantial market power and bancassurance exceeded the performance of the rest of the industry.

Compulsory insurance contract in private international law

Compulsory insurance is present in a vast majority of countries in the world and in all European countries. As international legal relations increasingly intensify, the market of cross-border insurance is also expanding. Despite entry into force of the provisions of the Rome I Regulation and the oncoming reform of the Brussels I bis Regulation, the European private international law, to the extent it governs compulsory insurance, is still a compromise. In the absence of a clear regime under the Rome I Regulation, doubts are still raised by the question of the pursuit for law applicable to group insurance contracts.

Improving Aviation Insurance System in Russia

The article is devoted to the study of aviation insurance system in Russia. The novelty is the presentation of aviation insurance as a system of elements. Within the framework of the study, the ranking of insurance companies by indicators of financial stability was carried out on the basis of the methodology proposed by Sberbank. The most stable company is National Insurance Group. An important result is the comparative analysis of aviation industry and aviation insurance industry in the period before and after the COVID-19 pandemic. As a part of the study, the dynamics of passenger traffic was analyzed, and the features of the formation of insurance rates before and after the announcement of the COVID-19 pandemic were revealed. The authors offer recommendations for insurance companies in order to help them overcome the crisis as soon as possible.

Does insurance type influence overall survival in patients with laryngeal squamous cell carcinoma?

ObjectivePatients with head and neck cancer with Medicaid or no insurance present at a more advanced stage and have lower survival. This study is one of the first to examine the relationship between specific insurance types and overall survival for laryngeal squamous cell carcinoma patients. Study designRetrospective chart review. SettingHenry Ford Cancer Institute. Subjects and methodsA retrospective database review was performed using the Henry Ford Virtual Data Warehouse Tumor Registry. Six hundred and fifty patients diagnosed with laryngeal squamous cell carcinoma were identified. Insurance groups analyzed were fee for service, health maintenance organization, Henry Ford Medical Group - a managed care type insurance, Medicare and Medicaid/uninsured. Cox proportional hazards and Kaplan-Meier curves were generated to analyze overall survival and display survival differences respectively. ResultsThe uninsured group had the lowest median survival time of 29.8 months (95% CI: 20.3–44.8) and the highest HR of 1.85 (95% CI 1.16–2.93) as compared to the HMO group at p < 0.001. Patients with fee for service insurance had longer overall survival compared to the other insurance types. Patients with fee for service insurance also had a high proportion of patients with advanced stage disease, but a younger mean age. Henry Ford Medical Group had a higher mean age and no statistically significant difference in survival when compared to fee for service. (p = 0.999) After controlling for socioeconomic status, insurance type remains a significant predictor of overall survival. ConclusionsFee for service had the highest overall survival of the different insurance types, but it was only statistically significant when compared to the Medicaid/uninsured group.

Annual Premium of Life in Insurance with Uniform Assumptions

This Study discusses life insurance for life with a uniform assumption method. The purpose of this study is to calculate the annual premium that must be paid by life insurance participants. This research was conducted at the General Insurance Group company, which is located on the street Arifin Ahmad. To determine the annual life insurance premium, the interest rate and discount factor, initial lifetime annuity, single premium, and the annual premium. After doing the research, the results of the calculation of the annual premium for life insurance for life using uniform assumptions for each participant life insurance are different. The amount of annual life insurance premiums uses a uniform assumption that is smaller than the annual life insurance premiums obtained from insurance companies.

Association of insurance disparities and survival in adults with multiple myeloma: A non-concurrent cohort study

BackgroundMultiple myeloma (MM) accounts for 10 % of all hematological malignancies. As recent advances in MM treatment continue to improve survival rates, socioeconomic barriers need to be identified to ensure equal treatment. This study evaluates the association between insurance status and survival in patients with MM. MethodsThis study analyzed patients with MM from the 2007–2016 Surveillance, Epidemiology, and End Results (SEER) Program database. Insurance status was categorized as uninsured, Medicaid, private insurance, and other insurance. Cancer-specific survival was measured at one- and five-years post diagnosis. ResultsFrom 2007–2016, there were 41,846 patients with MM extracted from the SEER database. Those with private insurance had a higher proportion of participants that identified as married (65.5 %), resided in metropolitan cities (90.1 %), and identified as white (76 %) and non-Hispanic (90.8 %). The uninsured group had the highest proportion of Black participants compared to other insurance groups (37.4 %). After adjustment for age, sex, race, ethnicity, marital status, and residence, the likelihood of five-year survival was significantly lower in those respondents with Medicaid (adjusted (adj) Hazard Ratio (HR): 1.44; 95 % Confidence Interval (CI): 1.36−1.53), when compared with private insurance holders. Those who were uninsured had a 26 % increased mortality hazard than those with private insurance (95 % CI 1.04−1.53). ConclusionAfter adjustment, insurance status can influence the survival of adults with MM. As treatment modalities for MM continue to advance, the insurance status of a patient should not hinder their ability to receive the most effective and timely therapies.

606 Association between in vitro fertilization and cesarean delivery among laboring nulliparous women

Exposure to in vitro fertilization (IVF) has been associated with an increased risk for cesarean delivery (CD). The aim of this study was to determine whether term nulliparous patients who conceived by IVF and labored are more likely to experience CD compared with patients who conceived without IVF (spontaneously, by induction of ovulation, or artificial insemination). Secondary analysis of a multicenter randomized trial in which low-risk nulliparous patients were assigned to induction of labor at 39 weeks or expectant management, at 41 hospitals across the US. Patients with antepartum stillbirth, major congenital malformations, and those who underwent elective, or pre-labor CD were excluded. The primary outcome for this analysis was CD. Univariate followed by multivariable analyses were conducted adjusting for advanced maternal age, obesity, private insurance, and treatment group. Mediation analysis was implemented considering type of labor, chorioamnionitis, hypertensive disorder of pregnancy, and dilation (≥ 5 cm and complete). P value of <0.05 was considered statistically significant. Of the 6,024 patients included in the analysis, 102 (1.7%) had IVF and these were more likely to be older, of White race, privately insured, married or living with a partner, and have had a prior pregnancy loss (all p< 0.01, Table 1). There were no significant differences in obstetrical characteristics (e.g. gestational age at delivery, type of labor, ripening agents or oxytocin use, or labor progress) or intrapartum morbidities (preeclampsia, abruption, or chorioamnionitis) between the two groups (Table 2). However, patients who conceived by IVF had higher odds of CD (30.4% vs. 19.5%, aOR 1.69, 95% CI 1.07-2.67, p=0.04) after adjusting for covariates. The mediating variables considered were not statistically significant with IVF, although the data are sparse. IVF was found to be associated with an increased odds of CD in laboring nulliparous women. These results may be of use for patient counseling before infertility treatment and at delivery time.View Large Image Figure ViewerDownload Hi-res image Download (PPT)

Racial and Ethnic Differences in Emergency Department Diagnostic Imaging at US Children’s Hospitals, 2016-2019

Diagnostic imaging is frequently performed as part of the emergency department (ED) evaluation of children. Whether imaging patterns differ by race and ethnicity is unknown. To evaluate racial and ethnic differences in the performance of common ED imaging studies and to examine patterns across diagnoses. This cross-sectional study evaluated visits by patients younger than 18 years to 44 US children's hospital EDs from January 1, 2016, through December 31, 2019. Non-Hispanic Black and Hispanic compared with non-Hispanic White race/ethnicity. The primary outcome was the proportion of visits for each race/ethnicity group with at least 1 diagnostic imaging study, defined as plain radiography, computed tomography, ultrasonography, and magnetic resonance imaging. The major diagnostic categories classification system was used to examine race/ethnicity differences in imaging rates by diagnoses. A total of 13 087 522 visits by 6 230 911 children and adolescents (mean [SD] age, 5.8 [5.2] years; 52.7% male) occurred during the study period. Diagnostic imaging was performed during 3 689 163 visits (28.2%). Imaging was performed in 33.5% of visits by non-Hispanic White patients compared with 24.1% of visits by non-Hispanic Black patients (odds ratio [OR], 0.60; 95% CI, 0.60-0.60) and 26.1% of visits by Hispanic patients (OR, 0.66; 95% CI, 0.66-0.67). Adjusting for confounders, visits by non-Hispanic Black (adjusted OR, 0.82; 95% CI, 0.82-0.83) and Hispanic (adjusted OR, 0.87; 95% CI, 0.87-0.87) patients were less likely to include any imaging study compared with visits by non-Hispanic White patients. Limiting the analysis to only visits by nonhospitalized patients, the adjusted OR for imaging was 0.79 (95% CI, 0.79-0.80) for visits by non-Hispanic Black patients and 0.84 (95% CI, 0.84-0.85) for visits by Hispanic patients. Results were consistent in analyses stratified by public and private insurance groups and did not materially differ by diagnostic category. In this study, non-Hispanic Black and Hispanic children were less likely to receive diagnostic imaging during ED visits compared with non-Hispanic White children. Further investigation is needed to understand and mitigate these potential disparities in health care delivery and to evaluate the effect of these differential imaging patterns on patient outcomes.