Exploring cultural barriers to pre -hospital emergency medical care: Analysis from observation

Many studies have documented racial and ethnic disparities in the US health care system. Historically, Black and Hispanic patients have had less access to health care services; moreover, they have had worse outcomes than White patients. While studies support the assertion that minority populations receive inferior quality and access to health services such as hospital care, much less is known about the quality of emergency care services in the pre-hospital setting.;This study focused on clinical and non-clinical factors associated with the quality of emergency medical care services. For example, some of the non-clinical factors included in this study were race, gender, ability to speak English, and age. This study also examined how diagnosis and treatment are influenced by the caregiver's cultural interpretation of verbal and non-verbal communications during the patient-provider interaction.;This study focused on two research questions: (1) What non-clinical factors are associated with differences in diagnosis and treatment of Emergency Medical Services patients? (2) Is there a difference in the diagnosis and subsequent treatment of patients who do not speak English? These questions were answered by analyzing patient demographic and treatment information from the community Emergency Medical Services system ambulance call reports, as well as demographic, treatment and discharge data from the receiving Emergency Department. The analysis used logistic regression models to identify variables associated with the delivery of appropriate emergency treatment to English and non-English speaking populations and participant observation as a means to identify how and why these variables effect patient outcomes.;The results of this study should help communities in two ways. First, it will help communities understand whether language barriers create disparities in delivering care. Second, it will also help Emergency Medical Services systems to identify ways to improve the delivery of care to diverse members of their communities.