Goldfarb Samantha, Dix Natalie, Spitz Austin, Graves Katelyn, Hansen Megan Deichen, Hogans-Mathews Shermeeka, Day Jessica, Harman Jeffrey
Florida State University College of Medicine, Department of Behavioral Sciences and Social Medicine, Tallahassee, Florida, United States of America.
Florida State University College of Medicine, Department of Family Medicine and Rural Health, Tallahassee, Florida, United States of America.
PLoS One. 2025 Aug 8;20(8):e0329376. doi: 10.1371/journal.pone.0329376. eCollection 2025.
The opioid/substance use disorder (SUD) epidemic in the United States has become a public health crisis. Stigma by health care workers towards patients with SUD has been identified as a barrier to treatment. Additionally, racial inequities in wait times and service provision have been found in Emergency Departments (EDs).
The purpose of this study was to examine the racial/ethnic differences in severity of ED triage assignment among visits for SUD.
This retrospective study utilized pooled data from the National Hospital Ambulatory Medical Care Survey (NHAMCS) from 2016-20. The dependent variable was the recorded triage level for patients with SUD. The independent variable was patient race/ethnicity. Analyses controlled for variables such as age, sex, and arrival by ambulance. Differences in triage level by race/ethnicity among visits by patients with SUD was assessed via multivariable logistic regression models.
Of the reported 788 SUD-specific ED visits from patients with SUD, 56.0% were non-Hispanic White, 28.6% were non-Hispanic Black, 12.9% were Hispanic, and 2.5% were of another race. Visits by Black patients with SUD had 53% lower odds of being assigned to an immediate/emergent triage level compared to visits by White patients with SUD (OR=0.47, p = .025).
We found that visits by Black patients with SUD were associated with lower odds of receiving an immediate/emergent triage assignment compared to visits by White patients with SUD, after adjusting for confounding variables. Our results suggest potential dual stigma in ED care of being Black and having a substance use disorder.
美国的阿片类药物/物质使用障碍（SUD）流行已成为一场公共卫生危机。医护人员对患有SUD的患者的污名化已被确定为治疗的障碍。此外，在急诊科（ED）发现了等待时间和服务提供方面的种族不平等现象。
本研究的目的是检查SUD就诊患者中急诊分诊分配严重程度的种族/民族差异。
这项回顾性研究利用了2016 - 20年国家医院门诊医疗调查（NHAMCS）的汇总数据。因变量是SUD患者记录的分诊级别。自变量是患者的种族/民族。分析控制了年龄、性别和救护车送达等变量。通过多变量逻辑回归模型评估SUD患者就诊时种族/民族在分诊级别上的差异。
在报告的788例SUD患者的特定急诊就诊中，56.0%是非西班牙裔白人，28.6%是非西班牙裔黑人，12.9%是西班牙裔，2.5%是其他种族。与患有SUD的白人患者就诊相比，患有SUD的黑人患者就诊被分配到立即/紧急分诊级别的几率低53%（OR = 0.47，p = 0.025）。
我们发现，在调整混杂变量后，与患有SUD的白人患者就诊相比，患有SUD的黑人患者就诊获得立即/紧急分诊分配的几率较低。我们的结果表明，在急诊科护理中，黑人身份和患有物质使用障碍可能存在双重污名。
