MSUCHM Symposium 2023 Abstract (Akhil Munagala(

Introduction: Depression is associated with various health risks, including an elevated likelihood of injuries and exacerbation of existing co-morbidities, resulting in an increased overall mortality rate. This study examines racial disparities in ED utilization among patients who are established with a primary care provider and have received a diagnosis of depression.

Methods: This is a retrospective cohort study examining ED visits without hospital admission within a 12-month timeframe among patients who received a new diagnosis of depression from their primary care provider. Data from electronic medical records (EMR) were collected from 47 family medicine clinics within a major healthcare system in Michigan. General linear regression models with Poisson distribution were used to predict frequency of ED visits. 

 Results: The study analyzed a total of 4,159 patients. Multivariable analyses exhibited that individuals who identify as Black/African American were associated with an additional 0.90 (95% CI, 0.64-1.16) ED visits, while those who identify as American Indian or Alaska Native were associated with an additional 1.39 (95% CI 0.92-1.87) ED visits compared to patients who identify as White or Caucasian (null value of 0). The effect sizes were only exceeded by patients who were prescribed typical antipsychotic medications.

 Conclusion: Despite prior research describing that racial minorities with mental health concerns often turn to EDs due to lack of access to primary care providers, our study revealed a similar pattern even among individuals who already have an established primary care provider. While we cannot definitively explain the motivations behind these participants’ ED visits, the racial disparities observed are striking and require further investigation and exploration.