Abstract
Background
Prolonged emergency department (ED) wait times could potentially lead to increased
mortality. Studies have demonstrated that black patients waited significantly longer
for ED care than nonblack patients. However, the disparity in wait times need not
necessarily manifest across all illness severities. We hypothesize that, on average,
black patients wait longer than nonblack patients and that the disparity is more pronounced
as illness severity decreases.
Methods
We studied 34143 patient visits in 353 hospital EDs in the National Hospital Ambulatory Medical
Care Survey in 2008. In a 2-model approach, we regressed natural logarithmically transformed
wait time on the race variable, other patient-level variables, and hospital-level
variables for 5 individually stratified illness severity categories. We reported results
as percent difference in wait times, with 95% confidence intervals. We used P < .05 for significance level.
Results
On average, black patients experienced significantly longer mean ED wait times than
white patients (69.2 vs 53.3 minutes; P < .001). In the multivariate model, black patients did not experience significant
different wait times for the 2 most urgent severity categories; black patients experienced
increasingly longer waits vs nonblack patients for the 3 least urgent severity categories
(14.7%, P < .05; 15.9%, P < .05; 29.9%, P < .001, respectively).
Conclusion
Racial disparity in ED wait times between black and nonblack patients exists, and
the size of the disparity is more pronounced as illness severity decreases. We do
not find a racial disparity in wait times for critically ill patients.
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Article Info
Publication History
Published online: September 07, 2015
Accepted:
August 31,
2015
Received in revised form:
August 20,
2015
Received:
July 20,
2015
Footnotes
☆Prior presentations: None.
☆☆Funding sources/disclosures: There are no conflicts of interest or financial disclosures to report.
Identification
Copyright
© 2015 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
