Kannikar Wechkunanukul1, Hugh Grantham2, David Teubner3, Karice K Hyun4, Robyn A Clark5. 1. School of Nursing and Midwifery, Flinders University, GPO BOX 2100, Adelaide, SA 5001, Australia. Electronic address: kannikar.w@flinders.edu.au. 2. Paramedic Department, Flinders University, GPO BOX 2100, Adelaide, SA 5001, Australia. Electronic address: hugh.grantham@flinders.edu.au. 3. Paramedic Department, Flinders University, GPO BOX 2100, Adelaide, SA 5001, Australia. Electronic address: david.teubner@flinders.edu.au. 4. The George Institute for Global Health, Cardiovascular division, Sydney Medical School, University of Sydney, Level 10, King George V Building, 83-117 Missenden Rd, Camperdown, NSW 2050, Australia. Electronic address: khyun@georgeinstitute.org.au. 5. School of Nursing and Midwifery, Flinders University, GPO BOX 2100, Adelaide, SA 5001, Australia. Electronic address: robyn.clark@flinders.edu.au.
Abstract
BACKGROUND: To date there has been limited published data presenting the characteristics and timeliness of the management in an Emergency Department (ED) for culturally and linguistically diverse (CALD) patients presenting with chest pain. This study aimed to describe the presenting characteristics and processing times for CALD patients with chest pain compared to the Australian-born population, and current guidelines. METHODS: This study was a cross sectional analysis of a cohort of patients who presented with chest pain to the metropolitan hospital between 1 July 2012 and 30 June 2014. RESULTS: Of the total study population (n=6640), 1241 (18.7%) were CALD and 5399 (81.3%) were Australian-born. CALD patients were significantly older than Australian-born patients (mean age 62 vs 56years, p<0.001). There were no differences in the proportion of patients who had central chest pain (74.9% vs 75.7%, p=0.526); ambulance utilisation (41.7% vs 41.1%, p=0.697); and time to initial treatment in ED (21 vs 22min, p=0.375). However, CALD patients spent a significantly longer total time in ED (5.4 vs 4.3h, p<0.001). There was no difference in guideline concordance between the two groups with low rates of 12.5% vs 13%, p=0.556. Nonetheless, CALD patients were 22% (95% CI, 0.65, 0.95, p=0.015) less likely to receive the guideline management for chest pain. CONCLUSIONS: The initial emergency care was equally provided to all patients in the context of a low rate of concordance with three chest pain related standards from the two guidelines. Nonetheless, CALD patients spent a longer time in ED compared to the Australian-born group.
BACKGROUND: To date there has been limited published data presenting the characteristics and timeliness of the management in an Emergency Department (ED) for culturally and linguistically diverse (CALD) patients presenting with chest pain. This study aimed to describe the presenting characteristics and processing times for CALD patients with chest pain compared to the Australian-born population, and current guidelines. METHODS: This study was a cross sectional analysis of a cohort of patients who presented with chest pain to the metropolitan hospital between 1 July 2012 and 30 June 2014. RESULTS: Of the total study population (n=6640), 1241 (18.7%) were CALD and 5399 (81.3%) were Australian-born. CALD patients were significantly older than Australian-born patients (mean age 62 vs 56years, p<0.001). There were no differences in the proportion of patients who had central chest pain (74.9% vs 75.7%, p=0.526); ambulance utilisation (41.7% vs 41.1%, p=0.697); and time to initial treatment in ED (21 vs 22min, p=0.375). However, CALD patients spent a significantly longer total time in ED (5.4 vs 4.3h, p<0.001). There was no difference in guideline concordance between the two groups with low rates of 12.5% vs 13%, p=0.556. Nonetheless, CALD patients were 22% (95% CI, 0.65, 0.95, p=0.015) less likely to receive the guideline management for chest pain. CONCLUSIONS: The initial emergency care was equally provided to all patients in the context of a low rate of concordance with three chest pain related standards from the two guidelines. Nonetheless, CALD patients spent a longer time in ED compared to the Australian-born group.
Authors: Thi Thu Le Pham; Janneke Berecki-Gisolf; Angela Clapperton; Kerry S O'Brien; Sara Liu; Katharine Gibson Journal: Int J Environ Res Public Health Date: 2021-01-16 Impact factor: 3.390