Are there demographic and socioeconomic disparities in adult patient selection for Extracorporeal Membrane Oxygenation?
There are significant sex and socioeconomic disparities in the selection of adult patients for ECMO in the United States.
Significant disparities exist in patient selection for ECMO. Female patients, patients with Medicaid, and patients living in the lowest-income neighborhoods are less likely to be treated with ECMO. Despite possible unmeasured confounding, these findings were robust to multiple sensitivity analyses. On the basis of previous work describing disparities in other areas of health care, we speculate that limited access in some neighborhoods, restrictive/biased interhospital transfer practices, differences in patient preferences, and implicit provider bias may contribute to the observed differences. Future studies with more granular data are needed to identify and modify drivers of observed disparities.
Mehta et al. (Thu,) studied this question.