Black patients wait longer in ER for hospital bed

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African-Americans who are admitted to the hospital after being seen in the emergency room wait about an hour longer than patients of other races for a hospital bed, according to a U.S. study.

Using data from 408 emergency departments nationwide, researchers at the University of Pennsylvania found that black ER patients waited an average of 367 minutes to be admitted to the intensive care unit (ICU), compared with 290 minutes for patients of other races.

The corresponding wait times for a non-ICU bed were 397 minutes versus 345 minutes, the researchers report in the journal Academic Emergency Medicine.

With non-ICU admissions, much of the racial disparity seemed to be related to differences among hospitals, the researchers found. That is, hospitals with a large proportion of black patients tended to have longer wait times to admission in general.

However, when it came to ICU admissions, African Americans had longer wait times than other emergency department (ED) patients in the same hospital.

The reasons for the disparity are not clear, according to Dr. Jesse M. Pines and his colleagues at the University of Pennsylvania, Philadelphia.

“What’s most concerning is that the longer people stay in the ED, the more likely they are to die,” Pines said in a news release from the university. “Our findings may actually explain some of the worse outcomes that we see in black populations.”

The “good news,” he said, is that the racial inequities are fixable. The “real problem,” according to Pines, is that many hospitals prioritize patients who have scheduled elective procedures, making ER patients wait for a bed.

“Now we know that minorities are disproportionately affected by this system,” Pines said.

Along with their longer average wait time for a hospital bed, African Americans were 42 percent more likely than other patients to have to wait more than 6 hours for an ICU bed.

It’s particularly concerning that the racial disparity was greater among the most sick or injured patients, according to the researchers.

“Some the greatest medical advancements of the last decade can be totally erased by spending a couple hours longer than necessary in the ED,” senior researcher Dr. Judd E. Hollander said in the statement.

“Even prior to the economic downturn,” he added, “some institutions had actually begun prioritizing hospital beds for insured patients having lucrative elective procedures. These measures will only worsen disparities for minorities.”

“Congress needs to make certain that ‘not for profit’ hospitals do not compromise patient care in pursuit of greater profits,” Hollander said.

SOURCE: Academic Emergency Medicine, online February 24, 2009.

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