Comparison of emergency department throughput and process times between male and female patients: A retrospective cohort investigation by the Reducing Disparities Increasing Equity in Emergency Medicine Study Group.

Autor: Onal EG; Department of Bioengineering University of Illinois at Urbana-Champaign Urbana Illinois USA.; Summer Foundations in Research Fellow Mayo Clinic Graduate School of Biomedical Sciences Mayo Clinic College of Medicine and Science Rochester Minnesota USA., Knier K; Mayo Clinic Alix School of Medicine Mayo Clinic College of Medicine and Science Rochester Minnesota USA.; Mayo Clinic Medical Scientist Training Program Mayo Clinic Graduate School of Biomedical Sciences Mayo Clinic College of Medicine and Science Rochester Minnesota USA., Hunt AW; Undergraduate Research Experience Program Mayo Clinic Graduate School of Biomedical Sciences Mayo Clinic College of Medicine and Science Rochester Minnesota USA., Knudsen JM; Office of Health Disparities Research Mayo Clinic College of Medicine and Science Rochester Minnesota USA., Nestler DM; Department of Emergency Medicine Mayo Clinic College of Medicine and Science Rochester Minnesota USA., Campbell RL; Department of Emergency Medicine Mayo Clinic College of Medicine and Science Rochester Minnesota USA., Thompson KM; Department of Emergency Medicine Mayo Clinic College of Medicine and Science Jacksonville Florida USA., Sunga KL; Department of Emergency Medicine Mayo Clinic College of Medicine and Science Rochester Minnesota USA.; Office of Equity Inclusion and Diversity Mayo Clinic Rochester Minnesota USA., Walker LE; Department of Emergency Medicine Mayo Clinic College of Medicine and Science Rochester Minnesota USA., Madsen BE; Department of Emergency Medicine Mayo Clinic College of Medicine and Science Rochester Minnesota USA., Sadosty AT; Department of Emergency Medicine Mayo Clinic College of Medicine and Science Rochester Minnesota USA., McGregor AJ; Sex and Gender Equity Committee Society of Academic Emergency Medicine Des Plaines Illinois USA.; Division of Sex and Gender in Emergency Medicine Department of Emergency Medicine Alpert Medical School Brown University Providence Rhode Island USA., Mullan AF; Department of Quantitative Health Sciences Mayo Clinic Rochester Minnesota USA., Jeffery MM; Department of Emergency Medicine Mayo Clinic College of Medicine and Science Rochester Minnesota USA.; Department of Quantitative Health Sciences Mayo Clinic Rochester Minnesota USA., Bellamkonda VR; Department of Emergency Medicine Mayo Clinic College of Medicine and Science Rochester Minnesota USA.
Jazyk: angličtina
Zdroj: Journal of the American College of Emergency Physicians open [J Am Coll Emerg Physicians Open] 2022 Sep 26; Vol. 3 (5), pp. e12792. Date of Electronic Publication: 2022 Sep 26 (Print Publication: 2022).
DOI: 10.1002/emp2.12792
Abstrakt: Introduction: Health equity for all patients is an important characteristic of an effective healthcare system. Bias has the potential to create inequities. In this study, we examine emergency department (ED) throughput and care measures for sex-based differences, including metrics such as door-to-room (DTR) and door-to-healthcare practitioner (DTP) times to look for potential signs of systemic bias.
Methods: We conducted an observational cohort study of all adult patients presenting to the ED between July 2015 and June 2017. We collected ED operational, throughput, clinical, and demographic data. Differences in the findings for male and female patients were assessed using Poisson regression and generalized estimating equations (GEEs). A priori, a clinically significant time difference was defined as 10 min.
Results: A total of 106,011 adult visits to the ED were investigated. Female patients had 8-min longer median length-of-stay (LOS) than males ( P < 0.01). Females had longer DTR (2-min median difference, P < 0.01), and longer DTP (5-min median difference, P  < 0.01). Females had longer median door-to-over-the-counter analgesia time (84 vs. 80, P = 0.58), door-to-advanced analgesia (95 vs. 84, P < 0.01), door-to-PO (by mouth) ondansetron (70 vs. 62, P = 0.02), and door-to-intramuscular/intravenous antiemetic (76 vs. 69, P  = 0.02) times compared with males.
Conclusion: Numerous statistically significant differences were identified in throughput and care measures-mostly these differences favored male patients. Few of these comparisons met our criteria for clinical significance.
Competing Interests: The authors declare no conflicts of interest.
(© 2022 The Authors. JACEP Open published by Wiley Periodicals LLC on behalf of American College of Emergency Physicians.)
Databáze: MEDLINE
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