The impact of race and disease on sickle cell patient wait times in the emergency department
Carlton Haywood Jr, Paula Tanabe, Rakhi Naik, Mary Catherine Beach, Sophie Lanzkron, Carlton Haywood Jr, Paula Tanabe, Rakhi Naik, Mary Catherine Beach, Sophie Lanzkron
Abstract
Study objective: To determine whether patients with sickle cell disease (SCD) experience longer wait times to see a physician after arrival to an emergency department (ED) compared to patients with long bone fracture and patients presenting with all other possible conditions (General Patient Sample), and to attempt to disentangle the effects of race and disease status on any observed differences.
Methods: A cross-sectional, comparative analysis of year 2003 through 2008 data from the National Hospital Ambulatory Medical Care Survey, a nationally representative sample of nonfederal emergency department visits in the United States. Our primary outcome was wait time (in minutes) to see a physician after arrival to an ED. A generalized linear model was used to examine ratios of wait times comparing SCD visits to the two comparison groups.
Results: SCD patients experienced wait times 25% longer than the General Patient Sample, though this difference was explained by the African-American race of the SCD patients. SCD patients waited 50% longer than did patients with long bone fracture even after accounting for race and assigned triage priority.
Conclusions: Patients with SCD presenting to an ED for care experience longer wait times than other groups, even after accounting for assigned triage level. The African-American race of the SCD patients, and their status as having SCD itself, both appear to contribute to longer wait times for these patients. These data confirm patient anecdotal reports and are in need of intervention.
Conflict of interest statement
Potential Conflicts of Interest: The governmental grant support reported above for Dr. Tanabe is for a project designed to improve the quality of emergency department care for persons with sickle cell disease. Some may perceive this as a potential conflict of interest. We certify that Dr. Tanabe’s study sponsors played no role in any aspect of the design of this study, the collection and analysis of data, or the interpretation of the results.
Copyright © 2013 Elsevier Inc. All rights reserved.
Source: PubMed