Navigation Links
Racial disparities in emergency department length of stay point to added risks for minority patients
Date:3/5/2009

(PHILADELPHIA) Sick or injured African-American patients wait about an hour longer than patients of other races before being transferred to an inpatient hospital bed following emergency room visits, according to a new national study published in the journal Academic Emergency Medicine. The authors say the findings underscore the urgency to find equitable, cost-effective solutions to provide better care in the nation's emergency departments, which are already strained by unprecedented crowding and more visits from the nation's uninsured population, which is expected to balloon toward 55 million people in the next decade.

"Emergency departments are not designed to care for patients for long time, but it happens all over the country," says lead author Jesse M. Pines, MD, MBA, MSCE, an assistant professor of Emergency Medicine and Epidemiology at the University of Pennsylvania School of Medicine and a senior fellow in Penn's Leonard Davis Institute of Health Economics. "What's most concerning is that the longer people stay in the ED, the more likely they are to die. Our findings may actually explain some of the worse outcomes that we see in black populations. But the good news is that these disparities are actually fixable. Hospitals do need to put more resources into EDs to improve efficiency, but the real problem is the on the 'back-end,' because hospitals tend to prioritize inpatient patients for elective procedures and make the ED patients wait. Now we know that minorities are disproportionately affected by this system."

In an examination of 14,516 hospital admissions from emergency departments in 408 U.S. hospitals between 2003 and 2005, the authors found a mean overall emergency room length of stay of 349 minutes. African-American patients, however, waited about an hour longer than those of other races, for admission to both intensive-care units and non-ICU beds. Despite adjusting for factors that might influence length of stay disparities, the authors were unable to identify a reason for the differences, though they say factors such as socioeconomic status or severity of patients' illnesses could play a role.

The disparity was most striking among the emergency departments' sickest patients, those admitted to ICUs. For black patients in this group, the mean length of stay in emergency departments was 367 minutes, compared to 290 minutes for non-African American patients. Fifty percent of black ICU patients also spent more than six hours waiting for an inpatient bed, compared to 37 percent of patients of other races. Since previous studies have linked emergency department boarding in excess of six hours to higher death rates among patients who are eventually admitted to ICUs, the authors say their findings may point to an added overall risk for minority patients.

Though admission from the emergency department requires an often complex matrix of steps, previous Penn research shows that prolonged emergency department stays before admission called "boarding" -- is associated with myriad complications and shortcomings in care for acutely ill patients. Among the costs: Higher death rates, poor pain control, and greater risk of delays in key treatments for illnesses like heart attacks, pneumonia, stroke and appendicitis.

The non-profit National Quality Forum, which works to develop national strategies for health care quality measurement and reporting recently approved a project that will establish several measures of emergency department waiting times (including amount of time before patients see a provider and overall length of stay). These will become a standard part of hospital quality measurement. Just as hospitals must reveal their compliance with recommended care for conditions including heart attack, surgical infections and pneumonia, these new measures will ensure that hospitals remain accountable for eliminating dangerous disparities.

"Some the greatest medical advancements of the last decade can be totally erased by spending a couple hours longer than necessary in the ED. It continues to perplex me as to why hospitals allow this to happen," says the study's senior author, Judd Hollander, MD, professor and director of clinical research in the department of Emergency Medicine. "Even prior to the economic downturn, some institutions had actually begun prioritizing hospital beds for insured patients having lucrative elective procedures. These measures will only worsen disparities for minorities. Congress needs to make certain that 'not for profit' hospitals do not compromise patient care in pursuit of greater profits."


'/>"/>

Contact: Holly Auer
holly.auer@uphs.upenn.edu
215-349-5659
University of Pennsylvania School of Medicine
Source:Eurekalert

Related medicine news :

1. Mailman School of Public Health study examines link between racial discrimination and substance use
2. Can racial health disparities be effectively reduced?
3. Racial and ethnic differences in colorectal cancer emphasize importance of screening
4. No racial differences seen in outcomes after liver transplantation
5. Genetic differences point to ethnic and racial disparities in colorectal cancer risk
6. Racial and ethnic differences in the biology of breast cancer tumors
7. Use of opioids for pain in ERs on the rise, but racial differences in use still exist
8. Racial disparities persist in cancer care
9. Despite efforts, significant racial disparities in cancer therapy still exist
10. March of Dimes Works to Eliminate Racial Gaps in Infant Health
11. National Business Group on Health to Hold Press Conference to Announce Partnership to Eliminate Racial and Ethnic Health Disparities
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:6/25/2016)... ... ... First Choice Emergency Room , the largest network of independent freestanding ... of its new Mesquite-Samuell Farm facility. , “We are pleased to announce Dr. ... James M. Muzzarelli, Executive Medical Director of First Choice Emergency Room. , Dr. ...
(Date:6/25/2016)... ... June 25, 2016 , ... On Friday, June 10, Van Mitchell, Secretary ... Work award to iHire in recognition of their exemplary accomplishments in worksite health promotion. ... Maryland Workplace Health & Wellness Symposium at the BWI Marriott in Linthicum Heights. iHire ...
(Date:6/24/2016)... ... June 24, 2016 , ... Those who have experienced traumatic events may suffer ... unhealthy avenues, such as drug or alcohol abuse, as a coping mechanism. To avoid ... healthy coping following a traumatic event. , Trauma sufferers tend to feel a range ...
(Date:6/24/2016)... ... 24, 2016 , ... The Pulmonary Hypertension Association (PHA) learned ... receive two significant new grants to support its work to advance research and ... by recognizing patients, medical professionals and scientists for their work in fighting pulmonary ...
(Date:6/24/2016)... ... June 24, 2016 , ... Comfort Keepers® of San Diego, CA ... the Road To Recovery® program to drive cancer patients to and from their cancer ... ensure the highest quality of life and ongoing independence. Getting to and from ...
Breaking Medicine News(10 mins):
(Date:6/24/2016)... , Belgium , June ... MKT: VNRX), today announced the appointment of Dr. ... of Directors as a Non-Executive Director, effective June ... Company,s Audit, Compensation and Nominations and Governance Committees.  ... Dr. Futcher will provide independent expertise and strategic ...
(Date:6/23/2016)... , June 23, 2016 Any dentist who ... challenges of the current process. Many of them do not ... the technical difficulties and high laboratory costs involved. And those ... offer it at such a high cost that the majority ... Dr. Parsa Zadeh , founder of Dental ...
(Date:6/23/2016)... , June 23, 2016 Research and ... Devices Medical Market Analysis 2016 - Forecast to 2022" ... The report contains up to date financial data derived ... Assessment of major trends with potential impact on the market ... of market segmentation which comprises of sub markets, regional and ...
Breaking Medicine Technology: