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Racial disparities in emergency department length of stay point to added risks for minority patients
Date:3/5/2009

sparities, the authors were unable to identify a reason for the differences, though they say factors such as socioeconomic status or severity of patients' illnesses could play a role.

The disparity was most striking among the emergency departments' sickest patients, those admitted to ICUs. For black patients in this group, the mean length of stay in emergency departments was 367 minutes, compared to 290 minutes for non-African American patients. Fifty percent of black ICU patients also spent more than six hours waiting for an inpatient bed, compared to 37 percent of patients of other races. Since previous studies have linked emergency department boarding in excess of six hours to higher death rates among patients who are eventually admitted to ICUs, the authors say their findings may point to an added overall risk for minority patients.

Though admission from the emergency department requires an often complex matrix of steps, previous Penn research shows that prolonged emergency department stays before admission called "boarding" -- is associated with myriad complications and shortcomings in care for acutely ill patients. Among the costs: Higher death rates, poor pain control, and greater risk of delays in key treatments for illnesses like heart attacks, pneumonia, stroke and appendicitis.

The non-profit National Quality Forum, which works to develop national strategies for health care quality measurement and reporting recently approved a project that will establish several measures of emergency department waiting times (including amount of time before patients see a provider and overall length of stay). These will become a standard part of hospital quality measurement. Just as hospitals must reveal their compliance with recommended care for conditions including heart attack, surgical infections and pneumonia, these new measures will ensure that hospitals remain accountable for eliminating dangerous disparities.

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Contact: Holly Auer
holly.auer@uphs.upenn.edu
215-349-5659
University of Pennsylvania School of Medicine
Source:Eurekalert

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