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. 2013 Sep;14(5):529-41.
doi: 10.5811/westjem.2013.3.12671.

Racial Disparity in Duration of Patient Visits to the Emergency Department: Teaching Versus Non-teaching Hospitals

Zeynal Karaca  1 , Herbert S Wong
Affiliations

Racial Disparity in Duration of Patient Visits to the Emergency Department: Teaching Versus Non-teaching Hospitals

Zeynal Karaca et al. West J Emerg Med. 2013 Sep.

Abstract

Introduction: 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.

Methods: 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.

Results: 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.

Conclusion: 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.

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Figures

Figure 1.
Figure 1.
Mean and median duration of routine visits to the hospital emergency departments. Data include all hospital emergency department routine visits that are discharged for home or self care during 2008 in Arizona, Massachusetts, and Utah. Duration is measured in minutes as the difference between admission time and discharge time for each visit.
Figure 2.
Figure 2.
Mean duration of routine visits to the hospital emergency departments of teaching hospitals. Data include all hospital emergency department routine visits that are discharged for home or self care during 2008 in Arizona, Massachusetts, and Utah. Duration is measured in minutes as the difference between admission time and discharge time for each visit.
Figure 3.
Figure 3.
Mean duration of routine visits to the hospital emergency departments of non-teaching hospitals. Data include all hospital emergency department routine visits that are discharged for home or self care during 2008 in Arizona, Massachusetts, and Utah. Duration is measured in minutes as the difference between admission time and discharge time for each visit.
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