Blacks Wait Longer for Hospital Bed, Study Finds

Disparity of up to an hour led to worse outcomes but it can be fixed

MONDAY, March 23, 2009 (HealthDay News) -- Compared to patients of other races, blacks have to wait about one hour longer before being transferred from the emergency department to an inpatient hospital bed, a new study shows.

That delay that may explain some of the worse health outcomes that occur among black patients, researchers say.

Their analysis of 14,516 hospital admissions from emergency departments in 408 U.S. hospitals between 2003 and 2005 showed that the overall average emergency room length of stay was 349 minutes. But black patients waited about an hour longer for admission to both intensive care units and non-ICU beds.

The disparity was most glaring among the sickest patients, those admitted to ICUs. The mean length of stay in the emergency department for black patients was 367 minutes, compared to 290 minutes for non-black patients. The study also found that 50 percent of black ICU patients spent more than six hours waiting for an inpatient bed, compared to 37 percent of patients of other races. Previous studies have linked spending more than six hours in an emergency department to higher death rates among patients eventually admitted to an ICU.

Even though they adjusted for factors that might influence length-of-stay disparities, the researchers couldn't identify a reason for the disparities. But they said factors such as a patient's severity of illness or socioeconomic status may play a role.

The findings, published in a recent issue of Academic Emergency Medicine, highlight the need to find equitable, cost-effective solutions to provide better care in the nation's emergency departments, the study authors said. They noted that emergency departments are under great strain, partly due to increasing numbers of uninsured patients, a group that's expected to grow to 55 million people in the next decade.

"Emergency departments are not designed to care for patients for a long time, but it happens all over the country," study author Dr. Jesse M. Pines, an assistant professor of emergency medicine and epidemiology at the University of Pennsylvania School of Medicine, said in a university news release.

"What's most concerning is that the longer people stay in the ED, the more likely they are to die. Our findings may actually explain some of the worse outcomes that we see in black populations. But the good news is that these disparities are actually fixable," Pines said.

"Hospitals do need to put more resources into EDs to improve efficiency, but the real problem is on the 'back-end,' because hospitals tend to prioritize inpatient patients for elective procedures and make the ED patients wait. Now we know that minorities are disproportionately affected by this system."

More information

The American College of Emergency Physicians explains what patients can expect in the emergency department.

SOURCE: University of Pennsylvania, news release, March 2009
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