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Variation in Emergency Department Wait Times for Children by Race/Ethnicity and Payment Source

Authors

  • Christine Y. Park,

    1. Avalere Health, 1350 Connecticut Avenue NW, Suite 900, Washington, DC 20036
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  • Mary Alice Lee,

    1. Division of Health Policy and Administration, Yale University School of Public Health, 60 College Street, New Haven, CT 06510
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  • Andrew J. Epstein

    1. Division of Health Policy and Administration, Yale University School of Public Health, 60 College Street, New Haven, CT 06510
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    • Address correspondence to Andrew J. Epstein, Ph.D., Division of Health Policy and Administration, Yale University School of Public Health, 60 College Street, New Haven, CT 06510; e-mail: andrew.epstein@yale.edu. Christine Y. Park, M.P.H., is at Avalere Health, 1350 Connecticut Avenue NW, Suite 900, Washington, DC 20036. Mary Alice Lee, Ph.D., is at theDivision of Health Policy and Administration, Yale University School of Public Health, 60 College Street, New Haven, CT 06510.


Abstract

Objective. To quantify the variation in emergency department (ED) wait times by patient race/ethnicity and payment source, and to divide the overall association into between- and within-hospital components.

Data Source. 2005 and 2006 National Hospital Ambulatory Medical Care Surveys.

Study Design. Linear regression was used to analyze the independent associations between race/ethnicity, payment source, and ED wait times in a pooled cross-sectional design. A hybrid fixed effects specification was used to measure the between- and within-hospital components.

Data Extraction Methods. Data were limited to children under 16 years presenting at EDs.

Principal Results. Unadjusted and adjusted ED wait times were significantly longer for non-Hispanic black and Hispanic children than for non-Hispanic white children. Children in EDs with higher shares of non-Hispanic black and Hispanic children waited longer. Moreover, Hispanic children waited 10.4 percent longer than non-Hispanic white children when treated at the same hospital. ED wait times for children did not vary significantly by payment source.

Conclusions. There are sizable racial/ethnic differences in children's ED wait times that can be attributed to both the racial/ethnic mix of children in EDs and to differential treatment by race/ethnicity inside the ED.

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