Skip to main content
Erschienen in: The Journal of Behavioral Health Services & Research 2/2018

16.08.2017

Disparities in Emergency Department Wait Time Among Patients with Mental Health and Substance-Related Disorders

verfasst von: Samuel T. Opoku, MBChB, PhD, Bettye A. Apenteng, PhD, Emmanuel A. Akowuah, MSc, Soumitra Bhuyan, MPH, PhD

Erschienen in: The Journal of Behavioral Health Services & Research | Ausgabe 2/2018

Einloggen, um Zugang zu erhalten

Abstract

This study examined disparities in emergency department (ED) wait time for patients with mental health and substance-related disorders (PwMHSDs), using data from the 2009–2011 National Hospital Ambulatory Medical Care Survey (NHAMCS). Wait time was defined as the time between arrival at ED and being seen by an ED provider. Results from multivariable regression models show racial disparities, with non-Hispanic Black PwMHSDs experiencing longer ED wait time, compared to non-Hispanic White PwMHSDs. A temporal decline in ED wait time was also observed over the study period. The findings of this study have implications for informing the development of policies tailored at facilitating the delivery of equitable emergency care services to all PwMHSDs.
Literatur
1.
Zurück zum Zitat Derlet RW, Richards JR. Overcrowding in the nation’s emergency departments: Complex causes and disturbing effects. Annals of Emergency Medicine. 2000; 35(1):63–68.CrossRefPubMed Derlet RW, Richards JR. Overcrowding in the nation’s emergency departments: Complex causes and disturbing effects. Annals of Emergency Medicine. 2000; 35(1):63–68.CrossRefPubMed
2.
Zurück zum Zitat Derlet RW, Richards JR, Kravitz RL. Frequent overcrowding in US emergency departments. Academic Emergency Medicine. 2001; 8(2):151–155.CrossRefPubMed Derlet RW, Richards JR, Kravitz RL. Frequent overcrowding in US emergency departments. Academic Emergency Medicine. 2001; 8(2):151–155.CrossRefPubMed
4.
Zurück zum Zitat Asplin BR, Magid DJ, Rhodes KV, et al. A conceptual model of emergency department crowding. Annals of Emergency Medicine. 2003; 42(2):173–180.CrossRefPubMed Asplin BR, Magid DJ, Rhodes KV, et al. A conceptual model of emergency department crowding. Annals of Emergency Medicine. 2003; 42(2):173–180.CrossRefPubMed
8.
Zurück zum Zitat Newton MF, Keirns CC, Cunningham R, et al. Uninsured adults presenting to US emergency departments: Assumptions vs data. Journal of the American Medical Association. 2008; 300(16):1914–1924.CrossRefPubMed Newton MF, Keirns CC, Cunningham R, et al. Uninsured adults presenting to US emergency departments: Assumptions vs data. Journal of the American Medical Association. 2008; 300(16):1914–1924.CrossRefPubMed
10.
Zurück zum Zitat Skinner HG, Blanchard J, Elixhauser A. Trends in emergency department visits, 2006–2011: Statistical brief #179. In: Healthcare cost and utilization project (HCUP) statistical briefs. Rockville (MD); 2014; 179. Skinner HG, Blanchard J, Elixhauser A. Trends in emergency department visits, 2006–2011: Statistical brief #179. In: Healthcare cost and utilization project (HCUP) statistical briefs. Rockville (MD); 2014; 179.
11.
Zurück zum Zitat Larkin GL, Claassen CA, Emond JA, et al. Trends in US emergency department visits for mental health conditions, 1992 to 2001. Psychiatric Services. 2005; 671–677. Larkin GL, Claassen CA, Emond JA, et al. Trends in US emergency department visits for mental health conditions, 1992 to 2001. Psychiatric Services. 2005; 671–677.
12.
Zurück zum Zitat Kne T, Young R, Spillane L. Frequent ED users: Patterns of use over time. American Journal of Emergency Medicine. 1998; 16(7):648–652.CrossRefPubMed Kne T, Young R, Spillane L. Frequent ED users: Patterns of use over time. American Journal of Emergency Medicine. 1998; 16(7):648–652.CrossRefPubMed
13.
Zurück zum Zitat Rask KJ, Williams MV, McNagny SE, et al. Ambulatory health care use by patients in a public hospital emergency department. Journal of General Internal Medicine. 1998; 13(9):614–620.CrossRefPubMedPubMedCentral Rask KJ, Williams MV, McNagny SE, et al. Ambulatory health care use by patients in a public hospital emergency department. Journal of General Internal Medicine. 1998; 13(9):614–620.CrossRefPubMedPubMedCentral
14.
Zurück zum Zitat Mandelberg JH, Kuhn RE, Kohn MA. Epidemiologic analysis of an urban, public emergency department's frequent users. Academic Emergency Medicine. 2000; 7(6):637–646.CrossRefPubMed Mandelberg JH, Kuhn RE, Kohn MA. Epidemiologic analysis of an urban, public emergency department's frequent users. Academic Emergency Medicine. 2000; 7(6):637–646.CrossRefPubMed
15.
Zurück zum Zitat Fisher JC, Mason RL, Keeley KA, et al. Physicians and alcoholics. The effect of medical training on attitudes toward alcoholics. Journal of Studies on Alcohol and Drugs. 1975; 36(7):949–955.CrossRef Fisher JC, Mason RL, Keeley KA, et al. Physicians and alcoholics. The effect of medical training on attitudes toward alcoholics. Journal of Studies on Alcohol and Drugs. 1975; 36(7):949–955.CrossRef
16.
Zurück zum Zitat Ewan CE, Whaite A. Training health professionals in substance abuse: A review. International Journal of the Addictions. 1982; 17(7):1211–1229.CrossRefPubMed Ewan CE, Whaite A. Training health professionals in substance abuse: A review. International Journal of the Addictions. 1982; 17(7):1211–1229.CrossRefPubMed
17.
Zurück zum Zitat Brewster JM, Single E, Ashley MJ, et al. Preventing alcohol problems: Survey of Canadian medical schools. Canadian Medical Association Journal. 1990; 143(10):1076–1082.PubMedPubMedCentral Brewster JM, Single E, Ashley MJ, et al. Preventing alcohol problems: Survey of Canadian medical schools. Canadian Medical Association Journal. 1990; 143(10):1076–1082.PubMedPubMedCentral
18.
Zurück zum Zitat Miller NS, Sheppard LM, Colenda CC, et al. Why physicians are unprepared to treat patients who have alcohol-and drug-related disorders. Academic Medicine. 2001; 7:410–418.CrossRef Miller NS, Sheppard LM, Colenda CC, et al. Why physicians are unprepared to treat patients who have alcohol-and drug-related disorders. Academic Medicine. 2001; 7:410–418.CrossRef
19.
Zurück zum Zitat Thornicroft G, Rose D, Kassam A. Discrimination in health care against people with mental illness. International Review of Psychiatry. 2007; 19(2):113–22.CrossRefPubMed Thornicroft G, Rose D, Kassam A. Discrimination in health care against people with mental illness. International Review of Psychiatry. 2007; 19(2):113–22.CrossRefPubMed
20.
Zurück zum Zitat Lawrence D, Kisely S. Review: Inequalities in healthcare provision for people with severe mental illness. Journal of Psychopharmacology. 2010; 24(4_suppl):61–8.CrossRefPubMedPubMedCentral Lawrence D, Kisely S. Review: Inequalities in healthcare provision for people with severe mental illness. Journal of Psychopharmacology. 2010; 24(4_suppl):61–8.CrossRefPubMedPubMedCentral
21.
Zurück zum Zitat Sun BC, Hsia RY, Weiss RE, et al. Effect of emergency department crowding on outcomes of admitted patients. Annals of Emergency Medicine. 2013; 61(6):605–611.e6CrossRefPubMed Sun BC, Hsia RY, Weiss RE, et al. Effect of emergency department crowding on outcomes of admitted patients. Annals of Emergency Medicine. 2013; 61(6):605–611.e6CrossRefPubMed
22.
Zurück zum Zitat Stone A, Rogers D, Kruckenberg S, et al. Impact of the mental health care delivery system on california emergency departments. Western Journal of Emergency Medicine. 2012; 13(1):51–56CrossRefPubMedPubMedCentral Stone A, Rogers D, Kruckenberg S, et al. Impact of the mental health care delivery system on california emergency departments. Western Journal of Emergency Medicine. 2012; 13(1):51–56CrossRefPubMedPubMedCentral
23.
Zurück zum Zitat Slade EP, Dixon LB, Semmel S. Trends in the duration of emergency department visits, 2001–2006. Psychiatric Services. 2010. Slade EP, Dixon LB, Semmel S. Trends in the duration of emergency department visits, 2001–2006. Psychiatric Services. 2010.
24.
Zurück zum Zitat Zeller S, Calma N, Stone A. Effects of a dedicated regional psychiatric emergency service on boarding of psychiatric patients in area emergency departments. Western Journal of Emergency Medicine. 2014; 15(1):1–6.CrossRefPubMedPubMedCentral Zeller S, Calma N, Stone A. Effects of a dedicated regional psychiatric emergency service on boarding of psychiatric patients in area emergency departments. Western Journal of Emergency Medicine. 2014; 15(1):1–6.CrossRefPubMedPubMedCentral
25.
Zurück zum Zitat Weiss AP, Chang G, Rauch SL, et al. Patient-and practice-related determinants of emergency department length of stay for patients with psychiatric illness. Annals of Emergency Medicine. 2012; 60(2):162–171.e5.CrossRefPubMed Weiss AP, Chang G, Rauch SL, et al. Patient-and practice-related determinants of emergency department length of stay for patients with psychiatric illness. Annals of Emergency Medicine. 2012; 60(2):162–171.e5.CrossRefPubMed
26.
Zurück zum Zitat Abid Z, Meltzer A, Lazar D, et al. Psychiatric Boarding in US EDs: A Multifactorial Problem that Requires Multidisciplinary Soultions. Urgent Matters. 2014;1(2):1–6 Abid Z, Meltzer A, Lazar D, et al. Psychiatric Boarding in US EDs: A Multifactorial Problem that Requires Multidisciplinary Soultions. Urgent Matters. 2014;1(2):1–6
27.
Zurück zum Zitat Pearlmutter MD, Dwyer KH, Burke LG, et al. Analysis of Emergency Department Length of Stay for Mental Health Patients at Ten Massachusetts Emergency Departments. Annals of Emergency Medicine. 2016; 1–10. Pearlmutter MD, Dwyer KH, Burke LG, et al. Analysis of Emergency Department Length of Stay for Mental Health Patients at Ten Massachusetts Emergency Departments. Annals of Emergency Medicine. 2016; 1–10.
29.
Zurück zum Zitat Hazlett SB, McCarthy ML, Londner MS, et al. Epidemiology of adult psychiatric visits to US emergency departments. Academic Emergency Medicine. 2004; 11(2):193–5.CrossRefPubMed Hazlett SB, McCarthy ML, Londner MS, et al. Epidemiology of adult psychiatric visits to US emergency departments. Academic Emergency Medicine. 2004; 11(2):193–5.CrossRefPubMed
30.
Zurück zum Zitat Wilper AP, Woolhandler S, Lasser KE, et al. Waits to see an emergency department physician: U.S. trends and predictors, 1997-2004. Health Affairs (Millwood). 2008; 27(2):w84–95. Wilper AP, Woolhandler S, Lasser KE, et al. Waits to see an emergency department physician: U.S. trends and predictors, 1997-2004. Health Affairs (Millwood). 2008; 27(2):w84–95.
31.
Zurück zum Zitat Richards ME, Hubble MW, Crandall C. Influence of ambulance arrival on emergency department time to be seen. Prehospital Emergency Care. 2006; 10(4):440–6.CrossRefPubMed Richards ME, Hubble MW, Crandall C. Influence of ambulance arrival on emergency department time to be seen. Prehospital Emergency Care. 2006; 10(4):440–6.CrossRefPubMed
32.
Zurück zum Zitat Park CY, Lee MA, Epstein AJ. Variation in emergency department wait time for children by race/ethnicity and payment source. Health Services Research. 2009; 44(6):2022–2039.CrossRefPubMedPubMedCentral Park CY, Lee MA, Epstein AJ. Variation in emergency department wait time for children by race/ethnicity and payment source. Health Services Research. 2009; 44(6):2022–2039.CrossRefPubMedPubMedCentral
33.
Zurück zum Zitat James CA, Bourgeois FT, Shannon MW. Association of race/ethnicity with emergency department wait time. Pediatrics. 2005; 115(3):e310–5.CrossRefPubMed James CA, Bourgeois FT, Shannon MW. Association of race/ethnicity with emergency department wait time. Pediatrics. 2005; 115(3):e310–5.CrossRefPubMed
34.
Zurück zum Zitat Schrader CD, Lewis LM. Racial disparity in emergency department triage. Journal of Emergency Medicine. 2013; 44(2):511–518.CrossRefPubMed Schrader CD, Lewis LM. Racial disparity in emergency department triage. Journal of Emergency Medicine. 2013; 44(2):511–518.CrossRefPubMed
35.
Zurück zum Zitat Sonnenfeld N, Pitts SR, Schappert SM, et al. Emergency department volume and racial and ethnic differences in waiting times in the united states. Medical Care. 2012; 50(4):335–341.CrossRefPubMed Sonnenfeld N, Pitts SR, Schappert SM, et al. Emergency department volume and racial and ethnic differences in waiting times in the united states. Medical Care. 2012; 50(4):335–341.CrossRefPubMed
36.
Zurück zum Zitat Okunseri C, Okunseri E, Chilmaza CA, et al. Racial and ethnic variations in waiting times for emergency department visits related to nontraumatic dental conditions in the United States. Journal of the American Dental Association. 2013; 144(7):828–836.CrossRefPubMedPubMedCentral Okunseri C, Okunseri E, Chilmaza CA, et al. Racial and ethnic variations in waiting times for emergency department visits related to nontraumatic dental conditions in the United States. Journal of the American Dental Association. 2013; 144(7):828–836.CrossRefPubMedPubMedCentral
37.
Zurück zum Zitat Pines JM, Russell LA, Hollander JE. Racial disparities in emergency department length of stay for admitted patients in the United States. Academic Emergency Medicine. 2009; 16(5):403–10.CrossRefPubMed Pines JM, Russell LA, Hollander JE. Racial disparities in emergency department length of stay for admitted patients in the United States. Academic Emergency Medicine. 2009; 16(5):403–10.CrossRefPubMed
38.
Zurück zum Zitat Uscher-Pines L, Pines J, Kellermann A, et al. Deciding to visit the emergency department for non-urgent conditions: a systematic review of the literature. American Journal of Managed Care. 2013; 19(1):47.PubMedPubMedCentral Uscher-Pines L, Pines J, Kellermann A, et al. Deciding to visit the emergency department for non-urgent conditions: a systematic review of the literature. American Journal of Managed Care. 2013; 19(1):47.PubMedPubMedCentral
39.
Zurück zum Zitat Zestcott CA, Blair IV, Stone J. Examining the presence, consequences, and reduction of implicit bias in health care: A narrative review. Group Processes & Intergroup Relations. 2016; 19(4):528–42.CrossRef Zestcott CA, Blair IV, Stone J. Examining the presence, consequences, and reduction of implicit bias in health care: A narrative review. Group Processes & Intergroup Relations. 2016; 19(4):528–42.CrossRef
40.
Zurück zum Zitat El Sayed MJ, El-Eid GR, Saliba M, et al. Improving emergency department door to doctor time and process reliability: A successful implementation of lean methodology. Medicine (Baltimore). 2015; 94(42):e1679.CrossRefPubMedPubMedCentral El Sayed MJ, El-Eid GR, Saliba M, et al. Improving emergency department door to doctor time and process reliability: A successful implementation of lean methodology. Medicine (Baltimore). 2015; 94(42):e1679.CrossRefPubMedPubMedCentral
41.
Zurück zum Zitat Alavi-Moghaddam M, Forouzanfar R, Alamdari S, et al. Application of queuing analytic theory to decrease waiting times in emergency department: Does it make sense? Archives of Trauma Research. 2012; 1(3):101–107.CrossRefPubMedPubMedCentral Alavi-Moghaddam M, Forouzanfar R, Alamdari S, et al. Application of queuing analytic theory to decrease waiting times in emergency department: Does it make sense? Archives of Trauma Research. 2012; 1(3):101–107.CrossRefPubMedPubMedCentral
42.
Zurück zum Zitat Kantonen J, Lloyd R, Mattila J, et al. Impact of an ABCDE team triage process combined with public guidance on the division of work in an emergency department. Scandinavian Journal of Primary Health Care. 2015; 33(2):74–81.CrossRefPubMedPubMedCentral Kantonen J, Lloyd R, Mattila J, et al. Impact of an ABCDE team triage process combined with public guidance on the division of work in an emergency department. Scandinavian Journal of Primary Health Care. 2015; 33(2):74–81.CrossRefPubMedPubMedCentral
43.
Zurück zum Zitat Cheng I, Lee J, Mittmann N, et al. Implementing wait-time reductions under Ontario government benchmarks (pay-for-results): A cluster randomized trial of the effect of a physician-nurse supplementary triage assistance team (MDRNSTAT) on emergency department patient wait time. BioMed Central Emergency Medicine. 2013; 13(1):1–10.CrossRef Cheng I, Lee J, Mittmann N, et al. Implementing wait-time reductions under Ontario government benchmarks (pay-for-results): A cluster randomized trial of the effect of a physician-nurse supplementary triage assistance team (MDRNSTAT) on emergency department patient wait time. BioMed Central Emergency Medicine. 2013; 13(1):1–10.CrossRef
44.
Zurück zum Zitat Hwang CE, Lipman GS, Kane M. Effect of an emergency department fast track on press-ganey patient satisfaction scores. Western Journal of Emergency Medicine. 2015; 16(1):34–38.CrossRefPubMed Hwang CE, Lipman GS, Kane M. Effect of an emergency department fast track on press-ganey patient satisfaction scores. Western Journal of Emergency Medicine. 2015; 16(1):34–38.CrossRefPubMed
45.
Zurück zum Zitat Boyle A, Beniuk K, Higginson I, et al. Emergency department crowding: Time for interventions and policy evaluations. Emergency Medicine International. 2012; 2012:1–8CrossRef Boyle A, Beniuk K, Higginson I, et al. Emergency department crowding: Time for interventions and policy evaluations. Emergency Medicine International. 2012; 2012:1–8CrossRef
46.
Zurück zum Zitat Polevoi SK, Jewel SJ, McCulloch CE, et al. Marked reduction in length of stay for patients with psychiatric emergencies after implementation of a comanagement model. Academic Emergency Medicine. 2013; 20(4):338–343.CrossRefPubMedPubMedCentral Polevoi SK, Jewel SJ, McCulloch CE, et al. Marked reduction in length of stay for patients with psychiatric emergencies after implementation of a comanagement model. Academic Emergency Medicine. 2013; 20(4):338–343.CrossRefPubMedPubMedCentral
48.
Zurück zum Zitat Ventres W, Haq C. Toward a cultural consciousness of self in relationship: from ‘us and them’ to ‘we’. Family Medicine. 2014; 46(9):691–695.PubMed Ventres W, Haq C. Toward a cultural consciousness of self in relationship: from ‘us and them’ to ‘we’. Family Medicine. 2014; 46(9):691–695.PubMed
49.
Zurück zum Zitat Cassel SG, Hadley AJ. A Pedagogical Note: Use of Telepractice to Link Student Clinicians to Diverse Populations. International Journal of Telerehabilitation. 2016; 8(1):41–45.CrossRefPubMedPubMedCentral Cassel SG, Hadley AJ. A Pedagogical Note: Use of Telepractice to Link Student Clinicians to Diverse Populations. International Journal of Telerehabilitation. 2016; 8(1):41–45.CrossRefPubMedPubMedCentral
50.
Zurück zum Zitat Sanchez K, Ybarra R, Chapa T, et al. Eliminating behavioral health disparities and improving outcomes for racial and ethnic minority populations. Psychiatric Services. 2015; 67(1):13–5.CrossRefPubMed Sanchez K, Ybarra R, Chapa T, et al. Eliminating behavioral health disparities and improving outcomes for racial and ethnic minority populations. Psychiatric Services. 2015; 67(1):13–5.CrossRefPubMed
Metadaten
Titel
Disparities in Emergency Department Wait Time Among Patients with Mental Health and Substance-Related Disorders
verfasst von
Samuel T. Opoku, MBChB, PhD
Bettye A. Apenteng, PhD
Emmanuel A. Akowuah, MSc
Soumitra Bhuyan, MPH, PhD
Publikationsdatum
16.08.2017
Verlag
Springer US
Erschienen in
The Journal of Behavioral Health Services & Research / Ausgabe 2/2018
Print ISSN: 1094-3412
Elektronische ISSN: 2168-6793
DOI
https://doi.org/10.1007/s11414-017-9565-8

Weitere Artikel der Ausgabe 2/2018

The Journal of Behavioral Health Services & Research 2/2018 Zur Ausgabe

Update Psychiatrie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.