Zook Heather G, Kharbanda Anupam B, Flood Andrew, Harmon Brian, Puumala Susan E, Payne Nathaniel R
Department of Research and Sponsored Programs, Children's Hospitals and Clinics of Minnesota, Minneapolis, Minnesota.
Department of Emergency Medicine, Children's Hospitals and Clinics of Minnesota, Minneapolis, Minnesota.
J Emerg Med. 2016 May;50(5):720-7. doi: 10.1016/j.jemermed.2015.02.056. Epub 2016 Feb 15.
Racial disparities are frequently reported in emergency department (ED) care.
To examine racial differences in triage scores of pediatric ED patients. We hypothesized that racial differences existed but could be explained after adjusting for sociodemographic and clinical factors.
We examined all visits to two urban, pediatric EDs between August 2009 and March 2010. Demographic and clinical data were electronically extracted from the medical record. We used logistic regression to analyze racial differences in triage scores, controlling for possible covariates.
There were 54,505 ED visits during the study period, with 7216 (13.2%) resulting in hospital admission. White patients accounted for 36.4% of visits, African Americans 28.5%, Hispanics 18.0%, Asians 4.1%, and American Indians 1.8%. After adjusting for potential confounders, African American (adjusted odds ratio [aOR] 1.89, 95% confidence interval [CI] 1.69-2.12), Hispanic (aOR 1.77, 95% CI 1.55-2.02), and American Indian (aOR 2.57, 95% CI 1.80-3.66) patients received lower-acuity triage scores than Whites. In three out of four subgroup analyses based on presenting complaints (breathing difficulty, abdominal pain, fever), African Americans and Hispanics had higher odds of receiving low-acuity triage scores. No racial differences were detected for patients with presenting complaints of laceration/head injury/arm injury. However, among patients admitted to the hospital, African Americans (aOR 1.47, 95% CI 1.13-1.90) and Hispanics (aOR 1.71, CI 1.22-2.39) received lower-acuity triage scores than Whites.
After adjusting for available sociodemographic and clinical covariates, African American, Hispanic, and American Indian patients received lower-acuity triage scores than Whites.
急诊科（ED）护理中经常报告种族差异。
研究儿科急诊患者分诊分数的种族差异。我们假设存在种族差异，但在调整社会人口统计学和临床因素后可以得到解释。
我们检查了2009年8月至2010年3月期间两家城市儿科急诊科的所有就诊情况。人口统计学和临床数据从电子病历中提取。我们使用逻辑回归分析分诊分数的种族差异，并控制可能的协变量。
研究期间共有54505次急诊就诊，其中7216次（13.2%）导致住院。白人患者占就诊人数的36.4%，非裔美国人占28.5%，西班牙裔占18.0%，亚裔占4.1%，美洲印第安人占1.8%。在调整潜在混杂因素后，非裔美国人（调整后的优势比[aOR]为1.89，95%置信区间[CI]为1.69 - 2.12）、西班牙裔（aOR为1.77，95% CI为1.55 - 2.02）和美洲印第安人（aOR为2.57，95% CI为1.80 - 3.66）患者的分诊分数低于白人。在基于主诉（呼吸困难、腹痛、发热）的四项亚组分析中，有三项显示非裔美国人和西班牙裔获得低分诊分数的几率更高。对于主诉为撕裂伤/头部受伤/手臂受伤的患者，未检测到种族差异。然而，在住院患者中，非裔美国人（aOR为1.47，95% CI为1.13 - 1.90）和西班牙裔（aOR为1.71，CI为1.22 - 2.39）的分诊分数低于白人。
在调整可用的社会人口统计学和临床协变量后，非裔美国人、西班牙裔和美洲印第安人患者的分诊分数低于白人。
