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. 2016 May;50(5):720-7.
doi: 10.1016/j.jemermed.2015.02.056. Epub 2016 Feb 15.

Racial Differences in Pediatric Emergency Department Triage Scores

Heather G Zook  1 , Anupam B Kharbanda  2 , Andrew Flood  1 , Brian Harmon  3 , Susan E Puumala  4 , Nathaniel R Payne  5
Affiliations

Racial Differences in Pediatric Emergency Department Triage Scores

Heather G Zook et al. J Emerg Med. 2016 May.

Abstract

Background: Racial disparities are frequently reported in emergency department (ED) care.

Objectives: To examine racial differences in triage scores of pediatric ED patients. We hypothesized that racial differences existed but could be explained after adjusting for sociodemographic and clinical factors.

Methods: We examined all visits to two urban, pediatric EDs between August 2009 and March 2010. Demographic and clinical data were electronically extracted from the medical record. We used logistic regression to analyze racial differences in triage scores, controlling for possible covariates.

Results: There were 54,505 ED visits during the study period, with 7216 (13.2%) resulting in hospital admission. White patients accounted for 36.4% of visits, African Americans 28.5%, Hispanics 18.0%, Asians 4.1%, and American Indians 1.8%. After adjusting for potential confounders, African American (adjusted odds ratio [aOR] 1.89, 95% confidence interval [CI] 1.69-2.12), Hispanic (aOR 1.77, 95% CI 1.55-2.02), and American Indian (aOR 2.57, 95% CI 1.80-3.66) patients received lower-acuity triage scores than Whites. In three out of four subgroup analyses based on presenting complaints (breathing difficulty, abdominal pain, fever), African Americans and Hispanics had higher odds of receiving low-acuity triage scores. No racial differences were detected for patients with presenting complaints of laceration/head injury/arm injury. However, among patients admitted to the hospital, African Americans (aOR 1.47, 95% CI 1.13-1.90) and Hispanics (aOR 1.71, CI 1.22-2.39) received lower-acuity triage scores than Whites.

Conclusion: After adjusting for available sociodemographic and clinical covariates, African American, Hispanic, and American Indian patients received lower-acuity triage scores than Whites.

Keywords: health disparities; pediatrics; race; triage.

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Conflict of interest statement

Disclosure statement: The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Flow diagram of study sample. Percentages are out of the original sample of 59 719 ED visits.
See this image and copyright information in PMC

References

    1. Park CY, Lee MA, Epstein AJ. Variation in emergency department wait times for children by race/ethnicity and payment source. Health Serv Res. 2009;44:2022–2039. - PMC - PubMed
    1. Mills AM, Shofer FS, Boulis AK, et al. Racial disparity in analgesic treatment for ED patients with abdominal or back pain. Am J Emerg Med. 2011;29:752–756. - PubMed
    1. Haywood C, Jr, Tanabe P, Naik R, et al. The impact of race and disease on sickle cell patient wait times in the emergency department. Am J Emerg Med. 2013;31:651–656. - PMC - PubMed
    1. Pletcher MJ, Kertesz SG, Kohn MA, et al. Trends in opioid prescribing by race/ethnicity for patients seeking care in US emergency departments. JAMA. 2008;299:70–78. - PubMed
    1. Payne NR, Puumala SE. Racial disparities in ordering laboratory and radiology tests for pediatric patients in the emergency department. Pediatr Emerg Care. 2013;29:598–606. - PubMed

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