Disparities in Adult Patient Selection for Extracorporeal Membrane Oxygenation in the United States: A Population-Level Study.

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. 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. Future studies with more granular data are needed to identify and modify drivers of observed disparities.