Determine if disparities exist in patient selection for ECMO based on gender, primary insurance, and median income of the patient's neighborhood.
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.
Based on previous work describing disparities in other areas of health care, we speculate that limited access in some neighborhoods, restrictive/biased inter-hospital transfer practices, differences in patient preferences, and implicit provider bias may contribute the observed differences.
Despite possible unmeasured confounding, these findings were robust to multiple sensitivity analyses.
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