Introduction: Despite the potential benefits of early screening, the effectiveness is dependent upon the disease incidence, the availability of the test, and a patient's access to care. This study examined disparities in... [ view full abstract ]
Introduction: Despite the potential benefits of early screening, the effectiveness is dependent upon the disease incidence, the availability of the test, and a patient's access to care. This study examined disparities in routine serum calcium screening within a health system where racial minority groups are adequately represented.
Methods: All patients at a large academic health center during 2011-2015 were included. Demographic and laboratory data in the Electronic Medical Record systems were analyzed to assess the calcium screening rates and incidence of hypercalcemia by age, gender, race, and insurance type. One way frequency, chi-square test of independence and multivariable analyses were conducted.
Results: 1,302,802 patients were evaluated, including 379,021 African Americans(28%), 20,398 Hispanics(2%), 13,022 Asians(1%), and 762,915 Caucasians(59%). Of these patients, 577,994(48%) had at least one serum calcium level recorded. Older age, male, black, and covered by Medicare are significantly associated with higher calcium screening rates. The screening rate in patients older than 65 was 57% versus 45% in their counterpart. Males had higher screening rate than female(51% vs. 46%). African Americans were more likely to have a serum calcium level drawn(52%) versus Caucasians(48%), Asians(44%), and Hispanics(35%). In addition, patients with Medicare were most likely to have calcium level screening(56%). The overall incidence of hypercalcemia was 2.2%, ranging from 0.9% in Asian males to 2.8% in African American females.
Conclusion: Significant disparities in laboratory testing exist, despite this the incidence of hypercalcemia is relative low, suggesting that routine screening of any group of patients is likely not cost effective.