Abstract
Objectives: Wait time for emergency care is a quality measure that affects clinical outcomes and patient satisfaction. It is unknown if there is racial/ethnic variability in this quality measure in pediatric emergency departments (PEDs). We aim to determine whether racial/ethnic differences exist in wait times for children presenting to PEDs and examine between-site and within-site differences. Methods: We conducted a retrospective cohort study for PED encounters in 2016 using the Pediatric Emergency Care Applied Research Network Registry, an aggregated deidentified electronic health registry comprising 7 PEDs. Patient encounters were included among all patients 18 years or younger at the time of the ED visit. We evaluated differences in emergency department wait time (time from arrival to first medical evaluation) considering patient race/ethnicity as the exposure. Results: Of 448,563 visits, median wait time was 35 minutes (interquartile range, 17–71 minutes). Compared with non-Hispanic White (NHW) children, non-Hispanic Black (NHB), Hispanic, and other race children waited 27%, 33%, and 12% longer, respectively. These differences were attenuated after adjusting for triage acuity level, mode of arrival, sex, age, insurance, time of day, and month [adjusted median wait time ratios (95% confidence intervals): 1.11 (1.10–1.12) for NHB, 1.12 (1.11–1.13) for Hispanic, and 1.05 (1.03–1.06) for other race children compared with NHW children]. Differences in wait time for NHB and other race children were no longer significant after adjusting for clinical site. Fully adjusted median wait times among Hispanic children were longer compared with NHW children [1.04 (1.03–1.05)].
| Original language | English (US) |
|---|---|
| Pages (from-to) | E929-E935 |
| Journal | Pediatric emergency care |
| Volume | 38 |
| Issue number | 2 |
| DOIs | |
| State | Published - Feb 1 2022 |
Funding
This project was supported by the National Institute of Minority Health and Disparities grant R03MD011654 (M.K.G.) and the Agency for Healthcare Research and Quality grant R01HS020270 (E.R.A.). The PECARN infrastructure was supported by the Health Resources and Services Administration (HRSA), the Maternal and Child Health Bureau, and the Emergency Medical Services for Children Network Development Demonstration Program under cooperative agreements U03MC00008, U03MC00001, U03MC00003, U03MC00006, U03MC00007, U03MC22684, and U03MC22685. The information or content and conclusions are those of the author and should not be construed as the official position or policy of nor should any endorsements be inferred by the HRSA, the Department of Health and Human Services, or the US government. No funding was secured for this study. The authors would like to acknowledge the PECARN Steering Committee and Subcommittees and the HRSA for their support of the PECARN Registry and this work. This project was supported by the National Institute of Minority Health and Disparities grant R03MD011654 (M.K.G.) and the Agency for Healthcare Research and Quality grant R01HS020270 (E.R.A.). The PECARN infrastructure was supported by the Health Resources and Services Administration (HRSA), the Maternal and Child Health Bureau, and the Emergency Medical Services for Children Network Development Demonstration Program under cooperative agreements U03MC00008, U03MC00001, U03MC00003, U03MC00006, U03MC00007, U03MC22684, and U03MC22685. The information or content and conclusions are those of the author and should not be construed as the official position or policy of nor should any endorsements be inferred by the HRSA, the Department of Health and Human Services, or the US government. No funding was secured for this study.
ASJC Scopus subject areas
- Pediatrics, Perinatology, and Child Health
- Emergency Medicine