Race/ethnicity-related and payer-related disparities in the timeliness of emergency care in U.S. emergency departments.

ABSTRACT

Our study objectives were to examine race/ethnicity-related and insurance-related differences in the timeliness of emergency care for a nationally representative sample of adults and to explore the role of uncertainty and location of care in explaining overall differences. We estimated a logistic regression model with hospital fixed effects to derive estimates of within-hospital group differences in the likelihood of waiting for more than 60 minutes to see a physician for several presenting conditions. We further estimated a model without hospital fixed effects to derive overall group differences. We observed race/ethnicity-related and payer-related differences in the timeliness of a medical screening exam for abdominal pain and chest pain visits but not for extremity laceration visits. Overall (within- and between-hospitals) differences in waiting time were due to patients receiving different care from the same hospital and from patients receiving care from different hospitals.