PHP6 - Racial Disparity In Duration Of Patients' Visits To The Emergency Department: Teaching Versus Non-Teaching Hospitals

Abstract

Racial disparity in duration of patients’ visits to emergency departments (EDs) have not been well documented. This study explores the racial disparity in duration of routine visits to EDs at teaching and non-teaching hospitals. Retrospective data analyses and multivariate regression analyses were performed to investigate the racial disparity in duration of routine ED visits at teaching and non-teaching hospitals. Duration for each visit was computed by taking the difference between admission and discharge times. 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. SEDD provide detailed diagnoses, procedures, total charges, patient demographics, and admission and discharge time for each visit. We linked SEDD files with American Hospital Association Annual Survey Database, Trauma Information Exchange Program Database and Area Resource File to obtain hospital and area level characteristics. 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 percent, respectively, at teaching hospitals; and longer by 3.6 and 13.8 percent, respectively, at non-teaching hospitals. Hispanic patients experienced 8.7 percent longer ED stays when compared to white patients at non-teaching hospitals. 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.