Isabella M Lichen1, Venkatesh R Bellamkonda2, Ronna L Campbell1, Sean M Phelan3, Joel R Anderson1, Aidan F Mullan4, Kit Knier5, Annie T Sadosty1. 1. Department of Emergency Medicine, Mayo Clinic, Rochester, MN, United States. 2. Department of Emergency Medicine, Mayo Clinic, Rochester, MN, United States. Electronic address: bellamkonda.venkatesh@mayo.edu. 3. Division of Health Care Delivery Research, Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, United States. 4. Department of Quantitative Health Sciences, Division of Clinical Trials and Biostatistics, Mayo Clinic, Rochester, MN, United States. 5. Mayo Clinic Alix School of Medicine, Mayo Clinic College of Medicine and Science, Rochester, MN, United States; Mayo Clinic Medical Scientist Training Program, Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic College of Medicine and Science, Rochester, MN, United States.
Abstract
OBJECTIVE: Numerous studies have demonstrated evidence of obesity bias in healthcare settings, however, little is known about obesity bias in the Emergency Department (ED). The objective of this study was to investigate obesity bias in an ED setting by assessing the association between body mass index (BMI) and door-to-room (DTR) or door-to-provider (DTP) times among ED patients. METHODS: We conducted an observational cohort study of all adult patient (age ≥ 18 years of age) visits to 21 Mayo Clinic and Mayo Clinic Health System EDs between November 1, 2018 and March 31, 2020. We compared DTR and DTP times based on BMI category. RESULTS: We found that median DTR and DTP times for adults with class 3 obesity are significantly shorter than patients in the normal weight category. For men with class 3 obesity, median DTR and DTP times were 7.5% and 5.4% shorter than men in the normal weight category. Relative to women in the normal weight category, the median DTR and DTP times were 4.6% and 3.8% faster for women in obesity class 1, 4.9% and 5.1% faster for women in obesity class 2, and DTR was 4.4% faster for women in obesity class 3. These percentage differences translated to slightly shorter wait times of 0.4-1.2 min compared to median wait times for patients with normal BMI. CONCLUSION: We did not find evidence of longer wait times experienced by people with obesity. Rather, patients with obesity often experienced wait times that were shorter than patients of normal weight.
OBJECTIVE: Numerous studies have demonstrated evidence of obesity bias in healthcare settings, however, little is known about obesity bias in the Emergency Department (ED). The objective of this study was to investigate obesity bias in an ED setting by assessing the association between body mass index (BMI) and door-to-room (DTR) or door-to-provider (DTP) times among ED patients. METHODS: We conducted an observational cohort study of all adult patient (age ≥ 18 years of age) visits to 21 Mayo Clinic and Mayo Clinic Health System EDs between November 1, 2018 and March 31, 2020. We compared DTR and DTP times based on BMI category. RESULTS: We found that median DTR and DTP times for adults with class 3 obesity are significantly shorter than patients in the normal weight category. For men with class 3 obesity, median DTR and DTP times were 7.5% and 5.4% shorter than men in the normal weight category. Relative to women in the normal weight category, the median DTR and DTP times were 4.6% and 3.8% faster for women in obesity class 1, 4.9% and 5.1% faster for women in obesity class 2, and DTR was 4.4% faster for women in obesity class 3. These percentage differences translated to slightly shorter wait times of 0.4-1.2 min compared to median wait times for patients with normal BMI. CONCLUSION: We did not find evidence of longer wait times experienced by people with obesity. Rather, patients with obesity often experienced wait times that were shorter than patients of normal weight.
Authors: Ege G Onal; Kit Knier; Alexander W Hunt; John M Knudsen; David M Nestler; Ronna L Campbell; Kristine M Thompson; Kharmene L Sunga; Laura E Walker; Bo E Madsen; Annie T Sadosty; Alyson J McGregor; Aidan F Mullan; Molly M Jeffery; Venkatesh R Bellamkonda Journal: J Am Coll Emerg Physicians Open Date: 2022-09-26