208874 Disparities in emergency room waititng times for chest pain patients

Tuesday, November 10, 2009

Patrick Neubert, MSPH, MSSA, LSW , Department of Health Policy and Management, Emory University, Atlanta, GA
Adam J. Atherly, PhD , Department of Health Systems, Management and Policy, Colorado School of Public Health, Aurora, CO
Kimberly J. Rask, MD, PhD , Department of Health Policy and Management, Rollins School of Public Health, Emory University, Atlanta, GA
Laura M. Gaydos, PhD , Department of Health Policy and Management, Rollins School of Public Health, Emory University, Atlanta, GA
Background

Patients presenting to the ED with a chief complaint of chest pain are to be considered a high priority. The American College of Cardiologist and the American Heart Association recommend an electrocardiogram be performed and shown to a physician within ten minutes of the patient's arrival. Clinicians from the Mayo Clinic suggest a physician's first encounter also be within ten minutes.

Purpose

Examine disparities in waiting times to see a physician for patients having chief complaint of chest pain.

Methods

Data were extracted from the 2003 2006 National Hospital Ambulatory Medical Care Survey. Only patients with a chief complaint of chest pain were included in the sample. A logit model was employed with a binary dependent variable of waiting less than 10 minutes or more than 10 minutes. Further the sample was stratified by triage status of emergent and non-emergent. The stratified sample used the dependent variable wait time and utilized a negative binomial regression model.

Results

African-Americans, urban areas, modes of arrival by private car or walk in, and patients triaged as non-emergent were found to have significantly longer wait times to see a physician. The uninsured were found to wait longer when triaged as non-emergent.

Conclusion

Only 30% of all chest pain patients and 40% of patients triaged as emergent were seen within the recommended ten minutes. While disparities did not exist due to insurance in emergent patients with chest pain, racial disparities affect all chest pain patients. African-Americans continue to be seen later than Caucasians.

Learning Objectives:
Identify disparities in emergency department waiting times for chest pain patients List significant predictors for prolonged wait times of chest pain patients Explain the need for chest pain patients to travel to the emergency department via ambulance

Keywords: Emergency Department/Room, Health Disparities

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have a Master's of Science in Social Administration. I have previously worked as an emergency room social worker for the Cleveland Clinic's Lutheran Hospital. I'm an MSPH candidate at Emory's Rollins School of Public Health and expected to complete my studies in May '09. This study was conducted for my thesis.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.