Disparities in Access to Advanced Life Support Revealed by Recent Study

A new study presented at the ATS 2025 International Conference sheds light on significant disparities in access to advanced life support, particularly extracorporeal membrane oxygenation (ECMO). Despite the increasing use of ECMO — a high-tech intervention that supports heart and lung function by oxygenating blood outside the body — many patients who could benefit from this treatment are not receiving it equitably. Surprisingly, the research found that disadvantaged patients, such as those who identify as Black, are less likely to receive ECMO even though they tend to live closer to hospitals that offer this service.

The study utilized a large clinical database to compare patients treated with ECMO versus those who received mechanical ventilation only. Researchers examined hospital capabilities and analyzed the geographical distance patients had to travel for ECMO services. Interestingly, they discovered that those from lower-income neighborhoods or with Medicaid were less frequently administered ECMO. Conversely, patients living in close proximity to ECMO-capable hospitals were not necessarily more likely to receive this advanced care, indicating that factors beyond mere distance influence access.

Hospitals with ECMO facilities often serve wealthier populations with higher rates of private insurance. The study hypothesizes that biases in provider decision-making, patient outreach, or hospital referral patterns may contribute to these disparities. Dr. Gwenyth L. Day from the University of Colorado highlighted that these findings point to the importance of developing clear guidelines and increasing funding for ECMO in safety-net hospitals to promote equitable healthcare.

The research underscores a broader issue: healthcare disparities are complex and affected by social, economic, and systemic biases. Future research aims to explore hospital transfer practices and their role in perpetuating these inequities. Addressing these gaps is vital for ensuring all patients have fair access to life-saving therapies.

(Source: https://medicalxpress.com/news/2025-05-highlights-disparities-access-advanced-life.html)