*EMBARGOED All research presented at the 2021 ACG Annual Scientific Meeting and Postgraduate Course is strictly embargoed until Sunday, October 24, 2021, at 3:30 pm EDT.
P1457 Disparities in Emergency Department Wait Times for Acute Gastrointestinal Bleeding: Results From the National Hospital Ambulatory Medical Care Survey, 2009-2018
Author Insight from Mohamad Aghaie Meybodi, MD, Rutgers New Jersey Medical School
What’s new here and important for clinicians?
Disparities related to race and ethnicity have been identified in several domains including access to health care and particularly acute care at the emergency department (ED). Prior studies have reported patient-level differences in access to timely ED care in multiple patient presentations, including myocardial infarction. However, to our knowledge, none have looked at race-based differences in patients presenting with GI bleeding. This concept is highlighted due to the worse outcome associated with delayed care of active GI bleed. The aim of our study was to identify if a disparity exists within different race groups, and to identify and overcome barriers to achieve equitable care. Our findings indicate that ED wait time is higher among African American as well as patients with charity care or self-paid. Interestingly, our data showed that even with similar insurance coverage, African American tend to experience higher wait time. The reason for racial disparities remains unclear although it is likely multifactorial and requires a multidisciplinary approach. These findings will help us to develop effective strategies addressing the racial disparities to reach racial equality in health care.
What do patients need to know?
The US Emergency Medical Treatment and Labor Act provided a mandate that all patients who present to an ED must be evaluated and treated for an emergency medical condition; however, there is no guidance on how quickly patients must be seen. ED wait times are an important indicator of the quality of care within a health system, and our findings indicate significant wait time gaps between different race groups. Adherence to a strict triage protocol could hypothetically reduce this gap, however, it is shown to be less effective. It could be hypothesized that this disparity is mainly driven by several factors and different root causes could be found in different zip code areas and neighborhoods. More studies are required to determine the effect size and causative factors contributing to this disparity and to develop policy actions to reduce this gap at the federal, state and local levels.
Mohamad Aghaie Meybodi, MD, Rutgers New Jersey Medical School
ma1740 [at] njms [dot] rutgers [dot] edu
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