232 Disparities in Emergency Department Wait Time Among Patients With Traumatic Brain Injury

Abstract

To identify characteristics among patients with traumatic brain injury associated with differences in emergency department wait time. Design/Setting: Secondary analysis of the 2003-2010 National Hospital Ambulatory Medical Care Survey was undertaken. We investigated patient characteristics associated with longer emergency department wait time until physician assessment through survey weighted multivariable analysis adjusting for patient, hospital, and severity factors. Patients: A total of 9,376,323 adult visits (>18 years old) presenting to emergency departments in the United States with traumatic brain injury. In total, 24.76% (2,321,476) of the visits were emergent (triage levels 1-2) with a mean wait time of 11.33 minutes (95% CI: 9.37, 13.70), and 65.13% (6,106,624) were non-emergent (triage levels 3-5) with a mean wait time of 21.99 minutes (95% CI: 18.28, 26.45) (P < .01). For emergent visits, patients 65+ years old waited 2.79 minutes longer (95% CI: 1.16, 5.19) compared to patients 19 to 64 years old, and African Americans waited 3.72 minutes longer (95% CI: 1.83, 6.55) compared to non-Hispanic white patients. For non-emergent visits, waiting time did not differ by age, but a racial disparity was present. African Americans waited 4.03 minutes (95% CI: 2.37, 6.31) compared to non-Hispanic White patients. There were age and racial disparities in wait time for traumatic brain injury visits in the emergency department. The racial disparity remained when looking at non-emergent visits. Based on these results, focus should be placed on explaining how patient age and race can affect emergency department wait times.