Variation in Emergency Department Wait Times for Children by Race/ethnicity and Payment Source

Overview

Journal Health Serv Res

Specialty Health Services

Date 2009 Sep 8

PMID 19732167

Citations 33

Authors

Christine Y Park

Mary Alice Lee

Andrew J Epstein

Affiliations

Soon will be listed here.

Abstract

Objective: To quantify the variation in emergency department (ED) wait times by patient race/ethnicity and payment source, and to divide the overall association into between- and within-hospital components.

Data Source: 2005 and 2006 National Hospital Ambulatory Medical Care Surveys.

Study Design: Linear regression was used to analyze the independent associations between race/ethnicity, payment source, and ED wait times in a pooled cross-sectional design. A hybrid fixed effects specification was used to measure the between- and within-hospital components.

Data Extraction Methods: Data were limited to children under 16 years presenting at EDs.

Principal Results: Unadjusted and adjusted ED wait times were significantly longer for non-Hispanic black and Hispanic children than for non-Hispanic white children. Children in EDs with higher shares of non-Hispanic black and Hispanic children waited longer. Moreover, Hispanic children waited 10.4 percent longer than non-Hispanic white children when treated at the same hospital. ED wait times for children did not vary significantly by payment source.

Conclusions: There are sizable racial/ethnic differences in children's ED wait times that can be attributed to both the racial/ethnic mix of children in EDs and to differential treatment by race/ethnicity inside the ED.

Citing Articles

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What explains differences in average wait time in the emergency department among different racial and ethnic populations: A linear decomposition approach.

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References

Manning W . The logged dependent variable, heteroscedasticity, and the retransformation problem. J Health Econ. 1998; 17(3):283-95. DOI: 10.1016/s0167-6296(98)00025-3. View

Bradley E, Herrin J, Wang Y, McNamara R, Webster T, Magid D . Racial and ethnic differences in time to acute reperfusion therapy for patients hospitalized with myocardial infarction. JAMA. 2004; 292(13):1563-72. DOI: 10.1001/jama.292.13.1563. View

Hasnain-Wynia R, Baker D, Nerenz D, Feinglass J, Beal A, Landrum M . Disparities in health care are driven by where minority patients seek care: examination of the hospital quality alliance measures. Arch Intern Med. 2007; 167(12):1233-9. DOI: 10.1001/archinte.167.12.1233. View

Derlet R, Richards J, Kravitz R . Frequent overcrowding in U.S. emergency departments. Acad Emerg Med. 2001; 8(2):151-5. DOI: 10.1111/j.1553-2712.2001.tb01280.x. View

Freeman H, Payne R . Racial injustice in health care. N Engl J Med. 2000; 342(14):1045-7. DOI: 10.1056/NEJM200004063421411. View

Schulman K, Berlin J, Harless W, Kerner J, Sistrunk S, Gersh B . The effect of race and sex on physicians' recommendations for cardiac catheterization. N Engl J Med. 1999; 340(8):618-26. DOI: 10.1056/NEJM199902253400806. View

GEIGER H . Race and health care--an American dilemma?. N Engl J Med. 1996; 335(11):815-6. DOI: 10.1056/NEJM199609123351110. View

Kressin N, Chang B, Hendricks A, Kazis L . Agreement between administrative data and patients' self-reports of race/ethnicity. Am J Public Health. 2003; 93(10):1734-9. PMC: 1448042. DOI: 10.2105/ajph.93.10.1734. View

Brillman J, Doezema D, Tandberg D, Sklar D, Davis K, Simms S . Triage: limitations in predicting need for emergent care and hospital admission. Ann Emerg Med. 1996; 27(4):493-500. DOI: 10.1016/s0196-0644(96)70240-8. View

10.

James C, Bourgeois F, Shannon M . Association of race/ethnicity with emergency department wait times. Pediatrics. 2005; 115(3):e310-5. DOI: 10.1542/peds.2004-1541. View

11.

Weissman J, Moy E, Campbell E, Gokhale M, Yucel R, Causino N . Limits to the safety net: teaching hospital faculty report on their patients' access to care. Health Aff (Millwood). 2003; 22(6):156-66. DOI: 10.1377/hlthaff.22.6.156. View

12.

Sarver J, Cydulka R, Baker D . Usual source of care and nonurgent emergency department use. Acad Emerg Med. 2002; 9(9):916-23. DOI: 10.1111/j.1553-2712.2002.tb02193.x. View

13.

Krishel S, Baraff L . Effect of emergency department information on patient satisfaction. Ann Emerg Med. 1993; 22(3):568-72. DOI: 10.1016/s0196-0644(05)81943-2. View

14.

Wuerz R, Fernandes C, Alarcon J . Inconsistency of emergency department triage. Emergency Department Operations Research Working Group. Ann Emerg Med. 1998; 32(4):431-5. DOI: 10.1016/s0196-0644(98)70171-4. View

15.

Calvin J, Roe M, Chen A, Mehta R, Brogan Jr G, DeLong E . Insurance coverage and care of patients with non-ST-segment elevation acute coronary syndromes. Ann Intern Med. 2006; 145(10):739-48. DOI: 10.7326/0003-4819-145-10-200611210-00006. View

16.

Rathore S, Krumholz H . Differences, disparities, and biases: clarifying racial variations in health care use. Ann Intern Med. 2004; 141(8):635-8. DOI: 10.7326/0003-4819-141-8-200410190-00011. View

17.

Manning W, Mullahy J . Estimating log models: to transform or not to transform?. J Health Econ. 2001; 20(4):461-94. DOI: 10.1016/s0167-6296(01)00086-8. View

18.

Bickell N, Hwang U, Anderson R, Rojas M, Barsky C . What affects time to care in emergency room appendicitis patients?. Med Care. 2008; 46(4):417-22. DOI: 10.1097/MLR.0b013e31815c1e66. View

19.

Wilper A, Woolhandler S, Lasser K, McCormick D, Cutrona S, Bor D . Waits to see an emergency department physician: U.S. trends and predictors, 1997-2004. Health Aff (Millwood). 2008; 27(2):w84-95. DOI: 10.1377/hlthaff.27.2.w84. View

20.

Forrest C, Simpson L, Clancy C . Child health services research. Challenges and opportunities. JAMA. 1997; 277(22):1787-93. View