Racial Disparity in Emergency Department Triage

Schrader, Chet D.; Lewis, Lawrence M.

doi:10.1016/j.jemermed.2012.05.010

Cited by 92 publications

(78 citation statements)

References 19 publications

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“…These findings are similar to those reported in a previous pediatric study and in several adult studies C of racial differences in triage scores (12-15). We were able to analyze interactions between race, insurance type, and distance from the ED, that to our knowledge have not been reported in previous triage studies.…”

Section: Discussionsupporting

confidence: 92%

“…The triage score may affect wait time to see an emergency physician, which can increase the risk of elopement and is associated with other ED outcome measures (1,3,5-6,9,11-12). Studies of racial differences in treatment or outcome measures often use triage scores to adjust for level of acuity, so any potential bias in the triage score may result in underestimated racial disparities in the pediatric ED (1-3,5,6,8,11).…”

Section: Discussionmentioning

confidence: 99%

“…While triage scores should estimate illness severity and anticipated resource utilization and are assumed to be assigned without systematic bias, they do contain a measure of subjectivity. Previous studies have reported an association between minority race and lower acuity ED triage scores for adults and in a single study of pediatric patients (12-14). However, studies of triage scores have often utilized national databases, which do not permit adjustment for socio-demographic determinants that influence ED utilization, such as income level and distance from the patient's residence to the ED (15).…”

Section: Introductionmentioning

confidence: 91%

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Racial Differences in Pediatric Emergency Department Triage Scores

Zook

Kharbanda

Flood

et al. 2016

The Journal of Emergency Medicine

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Background Racial disparities are frequently reported in emergency department (ED) care. Objectives To examine racial differences in triage scores of pediatric ED patients. We hypothesized that racial differences existed but could be explained after adjusting for socio-demographic and clinical factors. Methods 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. Results 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, CI 1.55 – 2.02), and American Indian (aOR 2.57, CI 1.80 – 3.66) patients received lower acuity triage scores than Whites. In 3 out of 4 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, CI 1.13 – 1.90) and Hispanics (aOR 1.71, CI 1.22 – 2.39) received lower acuity triage scores than Whites. Conclusion After adjusting for available socio-demographic and clinical covariates, African American, Hispanic, and American Indian patients received lower acuity triage scores than Whites.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 91%

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Racial Differences in Pediatric Emergency Department Triage Scores

Zook

Kharbanda

Flood

et al. 2016

The Journal of Emergency Medicine

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“…28,29 We do not know whether African-American patients or any of the other ethnic groups suffered more or received lower quality ED care than NHW patients, as has been demonstrated in other studies, 30–36 and additional prospective research is needed to determine how ESI assignments affect healthcare quality and outcomes. At the very least, and consistent with prior research 9 we suspect that higher pain scores did reflect patient's motivation to seek immediate attention and less urgent ESI scores on average did result in longer wait times in the ED, which has been linked to poorer outcomes in a variety of diseases, such as myocardial infarction, 37 stroke, 38 and sepsis. 39 …”

Section: Discussionsupporting

confidence: 74%

Patient Ethnicity Affects Triage Assessments and Patient Prioritization in U.S. Department of Veterans Affairs Emergency Departments

et al. 2016

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“…It can be used for comparing patient sets across hospitals, specialties, and departments. 3 Triage is a way for emergency departments to prioritize patients by acuity level into categories indicating how quickly they should be seen by a health provider (National Center for Health Statistics, 2013;Schrader and Lewis, 2013). The acuity of visits is classified internationally into four categories: emergent, urgent, semi-urgent, and non-urgent.…”

Section: Variables and Measuresmentioning

confidence: 99%

The embeddedness of organizational performance: Multiple Membership Multiple Classification Models for the analysis of multilevel networks

Tranmer

Pallotti

Lomi³

2016

Social Networks

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Tranmer, M., Pallotti, F., and Lomi, A. (2016) The embeddedness of organizational performance: multiple membership multiple classification models for the analysis of multilevel networks. Social Networks, 44, There may be differences between this version and the published version. You are advised to consult the publisher's version if you wish to cite from it.http://eprints.gla.ac.uk/122367/ hospitals (higher-level, elective transfers), and between EDs and hospitals (cross-level, nonemergency transfers). Our main analytical objective is to examine the effect of these interdependent and partially nested levels of action on the variation in waiting time among EDsone of the most commonly adopted and accepted measures of ED performance. After controlling for institutional and organizational differences between hospitals, we find that the largest component of network variation in patient waiting-time is accounted for at the level of the hospital-to-hospital patient transfers. We take this result as clear evidence of the presence of multilevel network effects on organizational sub-unit performance. We also find that EDs connected by direct patient transfer relations tend to attain similar levels of performance. We interpret this performance spillover effect as evidence that collaborative network relations afford and sustain processes of interorganizational learning and knowledge transfer at the sub-unit level. We discuss further extensions to the model for more general analyses of multilevel network dependencies.

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Racial Disparity in Emergency Department Triage

Cited by 92 publications

References 19 publications

Racial Differences in Pediatric Emergency Department Triage Scores

Racial Differences in Pediatric Emergency Department Triage Scores

Patient Ethnicity Affects Triage Assessments and Patient Prioritization in U.S. Department of Veterans Affairs Emergency Departments

The embeddedness of organizational performance: Multiple Membership Multiple Classification Models for the analysis of multilevel networks

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