Social and Scientific Systems, Inc., Silver Spring, Maryland ; Agency for Healthcare Research and Quality, Rockville, Maryland ; George Washington University, Health Policy Department, Washington, DC.
West J Emerg Med. 2013 Sep;14(5):529-41. doi: 10.5811/westjem.2013.3.12671.
The sources of racial disparity in duration of patients' visits to emergency departments (EDs) have not been documented well enough for policymakers to distinguish patient-related factors from hospital- or area-related factors. This study explores the racial disparity in duration of routine visits to EDs at teaching and non-teaching hospitals.
We performed retrospective data analyses and multivariate regression analyses to investigate the racial disparity in duration of routine ED visits at teaching and non-teaching hospitals. The Healthcare Cost and Utilization Project (HCUP) State Emergency Department Databases (SEDD) were used in the analyses. The data include 4.3 million routine ED visits encountered in Arizona, Massachusetts, and Utah during 2008. We computed duration for each visit by taking the difference between admission and discharge times.
The mean duration for a routine ED visit was 238 minutes at teaching hospitals and 175 minutes at non-teaching hospitals. There were significant variations in duration of routine ED visits across race groups at teaching and non-teaching hospitals. The risk-adjusted results show that the mean duration of routine ED visits for Black/African American and Asian patients when compared to visits for white patients was shorter by 10.0 and 3.4%, respectively, at teaching hospitals; and longer by 3.6 and 13.8%, respectively, at non-teaching hospitals. Hispanic patients, on average, experienced 8.7% longer ED stays when compared to white patients at non-teaching hospitals.
There is significant racial disparity in the duration of routine ED visits, especially in non-teaching hospitals where non-White patients experience longer ED stays compared to white patients. The variation in duration of routine ED visits at teaching hospitals when compared to non-teaching hospitals was smaller across race groups.
患者在急诊科就诊时间的种族差异的来源尚未得到充分记录，以至于政策制定者无法区分患者相关因素与医院或地区相关因素。本研究探讨了教学医院和非教学医院常规急诊科就诊时间的种族差异。
我们进行了回顾性数据分析和多变量回归分析，以调查教学医院和非教学医院常规急诊科就诊时间的种族差异。分析中使用了医疗保健成本和利用项目（HCUP）州急诊科数据库（SEDD）。数据包括 2008 年在亚利桑那州、马萨诸塞州和犹他州遇到的 430 万例常规急诊科就诊。我们通过减去入院和出院时间来计算每次就诊的持续时间。
教学医院常规急诊科就诊的平均持续时间为 238 分钟，非教学医院为 175 分钟。在教学医院和非教学医院，不同种族群体的常规急诊科就诊持续时间存在显著差异。风险调整后的结果表明，与白人患者相比，黑人/非裔美国人和亚裔患者的常规急诊科就诊持续时间分别缩短了 10.0%和 3.4%，而非教学医院则分别延长了 3.6%和 13.8%。与白人患者相比，西班牙语裔患者在非教学医院的急诊停留时间平均延长了 8.7%。
常规急诊科就诊时间存在显著的种族差异，尤其是在非教学医院，非白人患者的就诊时间比白人患者长。与非教学医院相比，教学医院各种族群体常规急诊科就诊持续时间的差异较小。
