Waiting for help: Predictors of emergency department wait time

The purpose of this study was to investigate the predictors of emergency department wait time in patients in general and in patients diagnosed with an acute myocardial infarction in the hospital emergency department in the United States. The ultimate intent of this work was to dissociate disparities in the quality of emergency care. The research questions of the study were tested using a publicly available large-scale population-based survey data, the Emergency Department dataset of the National Hospital Ambulatory Medical Care Survey, collected by the Centers for Disease Control and Prevention (CDC)'s National Center for Health Statistics in 2008. The investigated predictors of hospital emergency department wait time were selected based on prior research, and the development of the conceptual model was guided by the theoretical perspective of social stratification with focus on health disparities. Three statistical software packages were utilized to analyze the data: Stata 12, SAS 9, and M Plus 7. The study findings revealed that hospital emergency department wait time can be predicted from multiple factors characteristic of the patient emergency department visit. In patients in general, emergency department wait time seems associated with urgency of care, patient gender and race, population percent poverty in patient zip code, mode of arrival to the emergency department, type of insurance coverage, type of hospital ownership, metropolitan statistical area status, and geographical region. Conditionality and mediation of the association between patient gender and wait time was tested. In patients diagnosed with an acute myocardial infarction at the time of visit to the emergency department, wait time appears associated with urgency of care, symptoms of chest pain reported at the time of seeking care, mode of arrival to the emergency department, type of insurance coverage, type of hospital ownership, metropolitan statistical area status, population percent poverty level in patient zip code, as well as patient gender. Implications for future research and practice implementation are discussed. Among them, coronary disease prevention attempts need to include educating health professionals who come in contact with patients needing emergency care about the evidence-based multi-factorial relationships that underlie the complex disparities in the quality of emergency care.