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- Title
An analysis of racial inequities in emergency department triage among patients with stroke-like symptoms in the United States.
- Authors
Neves, Gabriel; DeToledo, John; Morris, James; Xu, K. Tom
- Abstract
Background: Racial inequities exist in treatment and outcomes in patients with acute stroke. Objectives: Our objective was to determine if racial inequities exist in the time-lapse between patient presentation and provider assessment in patients with stroke-like symptoms in Emergency Departments (ED) across the U.S. Methods: This study is a retrospective, observational study of the National Hospital Ambulatory Medical Care Survey (NHAMCS) 2014–2018. We identified visits with stroke-like symptoms and stratified the proportion of door-to-provider (DTP) times by racial groups. We used broad and narrow definitions of stroke-like symptoms. We performed bivariate and multivariate analyses using race and clinical and demographic characteristics as covariates. Results: Between 2014–2018, there were an average of 138.58 million annual ED visits. Of the total ED visits, 0.36% to 7.39% of the ED visits presented with stroke-like symptoms, and the average DTP time ranged from 39 to 49 min. The proportion of the visits with a triage level of 1 (immediate) or 2 (emergent) ranged from 16.03% to 23.27% for stroke-like symptoms. We did not find statistically significant racial inequities in DTP or ED triage level. We found significantly longer DTP times in non-Hispanic blacks (15.88 min, 95% CI: 4.29–27.48) and Hispanics (by 14.77 min, 95% CI: 3.37–26.16) than non-Hispanic whites that presented with atypical stroke-like symptoms. We observed that non-Hispanic whites were significantly more diagnosed with a stroke/TIA than other racial minority groups (p = 0.045) for atypical stroke-like symptoms. Conclusion: In our population-based analysis, we did not identify systemic racial inequities in the DTP times or ED triage level at ED triage for stroke-like symptoms.
- Subjects
UNITED States; RACIAL inequality; TRANSIENT ischemic attack; MEDICAL triage; HOSPITAL emergency services; OUTPATIENT services in hospitals; MEDICAL care surveys
- Publication
BMC Emergency Medicine, 2023, Vol 23, Issue 1, p1
- ISSN
1471-227X
- Publication type
Article
- DOI
10.1186/s12873-023-00865-z