Leora I Horwitz1, Elizabeth H Bradley. 1. Department of Internal Medicine, Yale University School of Medicine, PO Box 208093, New Haven, CT 06520-8093, USA.
Abstract
BACKGROUND: The wait time to see a physician in US emergency departments (EDs) is increasing and may differentially affect patients with varied insurance status and racial/ethnic backgrounds. METHODS: Using a stratified random sampling of 151 999 visits, representing 539 million ED visits from 1997 to 2006, we examined trends in the percentage of patients seen within the triage target time by triage category (emergent, urgent, semiurgent, and nonurgent), payer type, and race/ethnicity. RESULTS: The percentage of patients seen within the triage target time declined a mean of 0.8% per year, from 80.0% in 1997 to 75.9% in 2006 (P < .001). The percentage of patients seen within the triage target time declined 2.3% per year for emergent patients (59.2% to 48.0%; P < .001) compared with 0.7% per year for semiurgent patients (90.6% to 84.7%; P < .001). In 2006, the adjusted odds of being seen within the triage target time were 30% lower than in 1997 (odds ratio, 0.70; 95% confidence interval, 0.55-0.89). The adjusted odds of being seen within the triage target time were 87% lower (odds ratio, 0.13; 95% confidence interval, 0.11-0.15) for emergent patients compared with semiurgent patients. Patients of each payment type experienced similar decreases in the percentage seen within the triage target over time (P for interaction = .24), as did patients of each racial/ethnic group (P = .05). CONCLUSIONS: The percentage of patients in the ED who are seen by a physician within the time recommended at triage has been steadily declining and is at its lowest point in at least 10 years. Of all patients in the ED, the most emergent are the least likely to be seen within the triage target time. Patients of all racial/ethnic backgrounds and payer types have been similarly affected.
BACKGROUND: The wait time to see a physician in US emergency departments (EDs) is increasing and may differentially affect patients with varied insurance status and racial/ethnic backgrounds. METHODS: Using a stratified random sampling of 151 999 visits, representing 539 million ED visits from 1997 to 2006, we examined trends in the percentage of patients seen within the triage target time by triage category (emergent, urgent, semiurgent, and nonurgent), payer type, and race/ethnicity. RESULTS: The percentage of patients seen within the triage target time declined a mean of 0.8% per year, from 80.0% in 1997 to 75.9% in 2006 (P < .001). The percentage of patients seen within the triage target time declined 2.3% per year for emergent patients (59.2% to 48.0%; P < .001) compared with 0.7% per year for semiurgent patients (90.6% to 84.7%; P < .001). In 2006, the adjusted odds of being seen within the triage target time were 30% lower than in 1997 (odds ratio, 0.70; 95% confidence interval, 0.55-0.89). The adjusted odds of being seen within the triage target time were 87% lower (odds ratio, 0.13; 95% confidence interval, 0.11-0.15) for emergent patients compared with semiurgent patients. Patients of each payment type experienced similar decreases in the percentage seen within the triage target over time (P for interaction = .24), as did patients of each racial/ethnic group (P = .05). CONCLUSIONS: The percentage of patients in the ED who are seen by a physician within the time recommended at triage has been steadily declining and is at its lowest point in at least 10 years. Of all patients in the ED, the most emergent are the least likely to be seen within the triage target time. Patients of all racial/ethnic backgrounds and payer types have been similarly affected.
Authors: Niels K Rathlev; John Chessare; Jonathan Olshaker; Dan Obendorfer; Supriya D Mehta; Todd Rothenhaus; Steven Crespo; Brendan Magauran; Kathy Davidson; Richard Shemin; Keith Lewis; James M Becker; Linda Fisher; Linda Guy; Abbott Cooper; Eugene Litvak Journal: Ann Emerg Med Date: 2007-01-16 Impact factor: 5.721
Authors: Emily A Wang; Clemens S Hong; Shira Shavit; Ronald Sanders; Eric Kessell; Margot B Kushel Journal: Am J Public Health Date: 2012-07-19 Impact factor: 9.308
Authors: Arjun K Venkatesh; Benjamin P Geisler; Jennifer J Gibson Chambers; Christopher W Baugh; J Stephen Bohan; Jeremiah D Schuur Journal: PLoS One Date: 2011-09-14 Impact factor: 3.240
Authors: Stephen Villa; Ellen J Weber; Steven Polevoi; Christopher Fee; Andrew Maruoka; Tina Quon Journal: Int J Qual Health Care Date: 2018-06-01 Impact factor: 2.038