Published online March 1, 2005
PEDIATRICS Vol. 115 No. 3 March 2005, pp. e310-e315 (doi:10.1542/peds.2004-1541)
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrowRequest Permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by James, C. A.
Right arrow Articles by Shannon, M. W.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by James, C. A.
Right arrow Articles by Shannon, M. W.
Related Collections
Right arrow Office Practice
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Facebook   Add to Reddit   Add to Technorati   Add to Twitter  
What's this?

ELECTRONIC ARTICLE

Association of Race/Ethnicity with Emergency Department Wait Times

Catherine A. James, MD, Florence T. Bourgeois, MD and Michael W. Shannon, MD, MPH

From the Division of Emergency Medicine, Children's Hospital Boston, and Department of Pediatrics, Harvard Medical School, Boston, Massachusetts

Objective. To determine whether wait times for children treated in emergency departments (EDs) nationally are associated with patient race/ethnicity.

Methods. Data were obtained from the National Hospital Ambulatory Medical Care Survey, which collects information on patient visits to EDs throughout the United States. We examined data for patients ≤15 years of age who presented to EDs during the 4-year period of 1997–2000. Sample weights were applied to the identified patient records to yield national estimates. For the purposes of this study, race/ethnicity was analyzed for 3 major groups, ie, non-Hispanic white (NHW), non-Hispanic black (NHB), and Hispanic white (HW).

Results. During the 4-year study period, 20633 patient visits were surveyed, representing a national sample of 92.9 million children ≤15 years of age. The race/ethnicity distribution included 9019 NHW children (59.5%), 3910 NHB children (23.9%), and 2991 HW children (16.6%). The wait time for all groups was 43.6 ± 1.7 minutes (mean ± SEM). There were significant unadjusted intergroup differences in wait times (38.5 ± 1.6 minutes, 48.7 ± 0.5 minutes, and 54.5 ± 0.1 minutes for NHW, NHB, and HW children, respectively). Visit immediacy (triage status), when reported, was categorized as <15 minutes for 2203 children (17.1%), 15 to 60 minutes for 5324 (41.4%), 1 to 2 hours for 3010 (25.1%), and >2 to 24 hours for 1910 (16.4%). There were significant unadjusted differences in triage status according to race, with 14.6% of NHW patients being placed in the >2-hour immediacy range, compared with 18.8% of NHB patients and 20.0% of HW patients. In a linear regression analysis with logarithmically transformed wait time as a dependent variable and with adjustment for potential confounders, including hospital location, geographic region, and payer status, both NHB and HW patients waited longer than NHW patients, although the results were statistically significant only for HW patients.

Conclusions. These nationally representative data suggest that children who come to EDs have wait times that vary according to race/ethnicity. There are several potential explanations for this observation, including discrimination, cultural incompetence, language barriers, and other social factors. These data and similar data from the National Hospital Ambulatory Medical Care Survey are useful in identifying nonclinical influences on the delivery of pediatric emergency care.

Key Words: race/ethnicity • emergency department • wait time

Abbreviations: NHAMCS, National Hospital Ambulatory Medical Care Survey • NHW, non-Hispanic white • NHB, non-Hispanic black • HW, Hispanic white • ED, emergency department • CI, confidence interval

Accepted Oct 19, 2004.


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Facebook Facebook   Add to Reddit Reddit   Add to Technorati Technorati   Add to Twitter Twitter    What's this?


This article has been cited by other articles:


Home page
 Health Aff (Millwood)Home page
A. P. Wilper, S. Woolhandler, K. E. Lasser, D. McCormick, S. L. Cutrona, D. H. Bor, and D. U. Himmelstein
Waits To See An Emergency Department Physician: U.S. Trends And Predictors, 1997-2004
Health Aff., March 1, 2008; 27(2): w84 - w95.
[Abstract] [Full Text] [PDF]