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02 Ethnic differences in prehospital conveyance in the East Midlands region of the UK: a retrospective cross-sectional study
  1. Betul Yalcin1,
  2. Aloysius Niroshan Siriwardena1,
  3. Graham Richard Law1,
  4. Ffion Curtis2
  1. 1University of Lincoln, UK
  2. 2University of Liverpool, UK


Background Few studies have investigated prehospital conveyance of people from ethnic minority communities. Our aim was to identify differences in prehospital conveyance for ethnic minority people compared with white British people in the East Midlands region, United Kingdom (UK).

Methods Using a cross-sectional design, we analysed retrospective electronic clinical data from a large UK ambulance service, East Midlands Ambulance Service NHS Trust (EMAS), which serves a population of 4.5 million, from 1 January 2018 to 31 December 2021. Patient self-reported ethnicity recorded by ambulance crew in attendance was the exposure using seven categories of white British, EU27 Countries, other white, Asian, black, mixed and any other. The outcome measure was the rate of conveyance to a hospital. Multivariable logistic regression was used to identify predictors of conveyance whilst accounting for sociodemographic characteristics including age, gender, ethnicity, NEWS2 score, socio-economic deprivation, and urban or rural place of attendance.

Results There were 2,324,439 patients who received an ambulance attendance including people of White (88.0%), non-White (6.3%) and unknown (5.7%) ethnicity. The proportion of Asian patients (3.8%) who received attendance from the ambulance service was higher than other ethnic minority backgrounds. After adjusting for age, gender, ethnicity, NEWS2 score, socio-economic deprivation, and urban or rural place of residence, Asian patients (Odds Ratio [OR] 0.81, 95% Confidence Interval [CI] 0.80, 0.82, p<0.001), Black patients (OR 0.90, 95% CI 0.88, 0.93, p<0.001), and mixed ethnicity patients (OR 0.92, 95% CI 0.89, 0.95, p<0.001) were significantly less likely than white patients to be conveyed to the hospital by ambulance.

Conclusions There were significant differences in prehospital conveyance for ethnic minority patients compared with white-British patients. These differences could be related to language and cultural barriers, and a limited understanding of the health system. More action is needed to tackle ethnic inequalities, reduce inequalities, and remove barriers to equal conveyance.

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