Gender Differences in the Quality of EMS Care Nationwide for Chest Pain and Out-of-Hospital Cardiac Arrest

Jannet F. Lewis, Scott L. Zeger, Ximin Li, N. Clay Mann, Craig Newgard, Suzanne Haynes, Susan F. Wood, Mengtao Dai, Alan E. Simon, Melissa L. McCarthy

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background: We sought to determine whether gender disparities exist in the prehospital management of chest pain (CP) or out-of-hospital cardiac arrest (OHCA) among patients who accessed the emergency medical services (EMS) system. Methods: We obtained 2010–2013 data from the National Emergency Medical Services Information System and identified all EMS activations for CP or OHCA by adults 40 years of age or older. We selected American Heart Association medications and procedures to manage cardiovascular events. We stratified women and men by age (<65 years vs. ≥65 years), race (White vs. Black), clinical condition (CP vs. OHCA), same EMS agency, and calendar year. We determined the gender-specific treatment proportions for each stratum and calculated the weighted percentage difference in treatment between women and men. Results: Approximately 2.4 million CP and 284,000 OHCA activations were analyzed. Women with CP received a lower percentage of recommended treatments than men. For every 100 EMS activations by women with CP, 2.8 fewer received aspirin (95% CI, −4.8 to −0.8). The greatest gap in CP care was that women were significantly less likely to be transported using lights and sirens than men (−4.6%; 95% CI, −8.7% to −0.5%). More than 90% of OHCA activations were resuscitated; however, women were significantly less likely to be resuscitated compared with men (−1.3%; 95% CI, −2.4% to −0.2%). Conclusions: Small to modest disparities between otherwise similar women and men in the EMS treatment of CP and OHCA suggest the need for further evaluation and research with detailed contextual and outcome data.

Original languageEnglish (US)
Pages (from-to)116-124
Number of pages9
JournalWomen's Health Issues
Volume29
Issue number2
DOIs
StatePublished - Mar 1 2019

Fingerprint

Out-of-Hospital Cardiac Arrest
medical services
Emergency Medical Services
Chest Pain
pain
gender-specific factors
activation
gender
Therapeutics
social stratum
Information Systems
Aspirin
information system
medication
Light
event

ASJC Scopus subject areas

  • Health(social science)
  • Obstetrics and Gynecology
  • Public Health, Environmental and Occupational Health
  • Maternity and Midwifery

Cite this

Gender Differences in the Quality of EMS Care Nationwide for Chest Pain and Out-of-Hospital Cardiac Arrest. / Lewis, Jannet F.; Zeger, Scott L.; Li, Ximin; Mann, N. Clay; Newgard, Craig; Haynes, Suzanne; Wood, Susan F.; Dai, Mengtao; Simon, Alan E.; McCarthy, Melissa L.

In: Women's Health Issues, Vol. 29, No. 2, 01.03.2019, p. 116-124.

Research output: Contribution to journalArticle

Lewis, JF, Zeger, SL, Li, X, Mann, NC, Newgard, C, Haynes, S, Wood, SF, Dai, M, Simon, AE & McCarthy, ML 2019, 'Gender Differences in the Quality of EMS Care Nationwide for Chest Pain and Out-of-Hospital Cardiac Arrest', Women's Health Issues, vol. 29, no. 2, pp. 116-124. https://doi.org/10.1016/j.whi.2018.10.007
Lewis, Jannet F. ; Zeger, Scott L. ; Li, Ximin ; Mann, N. Clay ; Newgard, Craig ; Haynes, Suzanne ; Wood, Susan F. ; Dai, Mengtao ; Simon, Alan E. ; McCarthy, Melissa L. / Gender Differences in the Quality of EMS Care Nationwide for Chest Pain and Out-of-Hospital Cardiac Arrest. In: Women's Health Issues. 2019 ; Vol. 29, No. 2. pp. 116-124.
@article{44243cc2375f4173a9343c6bd83cccf6,
title = "Gender Differences in the Quality of EMS Care Nationwide for Chest Pain and Out-of-Hospital Cardiac Arrest",
abstract = "Background: We sought to determine whether gender disparities exist in the prehospital management of chest pain (CP) or out-of-hospital cardiac arrest (OHCA) among patients who accessed the emergency medical services (EMS) system. Methods: We obtained 2010–2013 data from the National Emergency Medical Services Information System and identified all EMS activations for CP or OHCA by adults 40 years of age or older. We selected American Heart Association medications and procedures to manage cardiovascular events. We stratified women and men by age (<65 years vs. ≥65 years), race (White vs. Black), clinical condition (CP vs. OHCA), same EMS agency, and calendar year. We determined the gender-specific treatment proportions for each stratum and calculated the weighted percentage difference in treatment between women and men. Results: Approximately 2.4 million CP and 284,000 OHCA activations were analyzed. Women with CP received a lower percentage of recommended treatments than men. For every 100 EMS activations by women with CP, 2.8 fewer received aspirin (95{\%} CI, −4.8 to −0.8). The greatest gap in CP care was that women were significantly less likely to be transported using lights and sirens than men (−4.6{\%}; 95{\%} CI, −8.7{\%} to −0.5{\%}). More than 90{\%} of OHCA activations were resuscitated; however, women were significantly less likely to be resuscitated compared with men (−1.3{\%}; 95{\%} CI, −2.4{\%} to −0.2{\%}). Conclusions: Small to modest disparities between otherwise similar women and men in the EMS treatment of CP and OHCA suggest the need for further evaluation and research with detailed contextual and outcome data.",
author = "Lewis, {Jannet F.} and Zeger, {Scott L.} and Ximin Li and Mann, {N. Clay} and Craig Newgard and Suzanne Haynes and Wood, {Susan F.} and Mengtao Dai and Simon, {Alan E.} and McCarthy, {Melissa L.}",
year = "2019",
month = "3",
day = "1",
doi = "10.1016/j.whi.2018.10.007",
language = "English (US)",
volume = "29",
pages = "116--124",
journal = "Women's Health Issues",
issn = "1049-3867",
publisher = "Elsevier USA",
number = "2",

}

TY - JOUR

T1 - Gender Differences in the Quality of EMS Care Nationwide for Chest Pain and Out-of-Hospital Cardiac Arrest

AU - Lewis, Jannet F.

AU - Zeger, Scott L.

AU - Li, Ximin

AU - Mann, N. Clay

AU - Newgard, Craig

AU - Haynes, Suzanne

AU - Wood, Susan F.

AU - Dai, Mengtao

AU - Simon, Alan E.

AU - McCarthy, Melissa L.

PY - 2019/3/1

Y1 - 2019/3/1

N2 - Background: We sought to determine whether gender disparities exist in the prehospital management of chest pain (CP) or out-of-hospital cardiac arrest (OHCA) among patients who accessed the emergency medical services (EMS) system. Methods: We obtained 2010–2013 data from the National Emergency Medical Services Information System and identified all EMS activations for CP or OHCA by adults 40 years of age or older. We selected American Heart Association medications and procedures to manage cardiovascular events. We stratified women and men by age (<65 years vs. ≥65 years), race (White vs. Black), clinical condition (CP vs. OHCA), same EMS agency, and calendar year. We determined the gender-specific treatment proportions for each stratum and calculated the weighted percentage difference in treatment between women and men. Results: Approximately 2.4 million CP and 284,000 OHCA activations were analyzed. Women with CP received a lower percentage of recommended treatments than men. For every 100 EMS activations by women with CP, 2.8 fewer received aspirin (95% CI, −4.8 to −0.8). The greatest gap in CP care was that women were significantly less likely to be transported using lights and sirens than men (−4.6%; 95% CI, −8.7% to −0.5%). More than 90% of OHCA activations were resuscitated; however, women were significantly less likely to be resuscitated compared with men (−1.3%; 95% CI, −2.4% to −0.2%). Conclusions: Small to modest disparities between otherwise similar women and men in the EMS treatment of CP and OHCA suggest the need for further evaluation and research with detailed contextual and outcome data.

AB - Background: We sought to determine whether gender disparities exist in the prehospital management of chest pain (CP) or out-of-hospital cardiac arrest (OHCA) among patients who accessed the emergency medical services (EMS) system. Methods: We obtained 2010–2013 data from the National Emergency Medical Services Information System and identified all EMS activations for CP or OHCA by adults 40 years of age or older. We selected American Heart Association medications and procedures to manage cardiovascular events. We stratified women and men by age (<65 years vs. ≥65 years), race (White vs. Black), clinical condition (CP vs. OHCA), same EMS agency, and calendar year. We determined the gender-specific treatment proportions for each stratum and calculated the weighted percentage difference in treatment between women and men. Results: Approximately 2.4 million CP and 284,000 OHCA activations were analyzed. Women with CP received a lower percentage of recommended treatments than men. For every 100 EMS activations by women with CP, 2.8 fewer received aspirin (95% CI, −4.8 to −0.8). The greatest gap in CP care was that women were significantly less likely to be transported using lights and sirens than men (−4.6%; 95% CI, −8.7% to −0.5%). More than 90% of OHCA activations were resuscitated; however, women were significantly less likely to be resuscitated compared with men (−1.3%; 95% CI, −2.4% to −0.2%). Conclusions: Small to modest disparities between otherwise similar women and men in the EMS treatment of CP and OHCA suggest the need for further evaluation and research with detailed contextual and outcome data.

UR - http://www.scopus.com/inward/record.url?scp=85062899608&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85062899608&partnerID=8YFLogxK

U2 - 10.1016/j.whi.2018.10.007

DO - 10.1016/j.whi.2018.10.007

M3 - Article

VL - 29

SP - 116

EP - 124

JO - Women's Health Issues

JF - Women's Health Issues

SN - 1049-3867

IS - 2

ER -