Women, Black Patients See Longer Emergency Department Wait Times

Women and Black patients with chest pain experienced longer emergency department wait times than their White, male counterparts, new data shows, shining a light on disparities in timely patient access to care.

These disparities are particularly troubling as chest pain is the most frequent symptom of heart attack for both men and women of all ages. Further, chest pain accounts for over 6.5 million emergency department (ED) visits annually in the United States. When someone has a heart attack, every minute counts, Harmony R. Reynolds, senior author of the study stated.

To conduct the study, researchers examined national survey data of more than 4,000 patients representing over 29 million ED visits for chest pain by adults age 55 and younger between 2014 and 2018.

The report highlighted how race and gender play a role in patient care access. Women waited nearly 11 minutes longer to be seen for chest pain in the ER compared to their male counterparts.

Not only did women experience greater wait times, but they also received a less thorough evaluation for a possible heart attack. Women were less likely to be admitted to the hospital or an observation unit than men.

Black patients waited the longest before being seen by a health care professional, the press release noted.

“Chest pain is the most common symptom of heart attack in adults of all ages. Despite a decline in the number of overall heart attacks, this number is rising among young adults,” said Darcy Banco, MD, MPH, lead author of the study and chief resident for safety and quality in the department of medicine at the NYU Grossman School of Medicine in New York City. 
“Young women and young Black adults have poorer outcomes after a heart attack compared to men and white adults,” Banco added.

Black women with chest pain waited 15 minutes longer than White women to be evaluated for chest pain in the ER. These delays can have serious implications for Black patients who already have an increased risk of death caused by premature heart attacks.

“Whether or not the differences in chest pain evaluation directly translate into differences in outcomes, they represent a difference in the care individuals receive based on their race or sex, and that is important for us to know,” Banco said

Researchers highlighted that the study had several limitations as it was not possible to review the details of each encounter to understand the reasons for delays. There was no information available regarding the evaluation, limiting research efforts.

Additional studies are needed to uncover the underlying reasons for these delays and to find opportunities to improve care, Banco said.

“The findings raise many questions for future research. Do differences in wait time vary with location?” Banco questioned. “Are the differences related to variation in hospital care quality, or are these differences applicable to all ERs? Lastly, do differences in wait time translate to differences in outcomes?”

However, reducing overall emergency department utilization can improve wait times for patients experiencing life-threatening symptoms. According to 2019 data from United Healthcare (UHC), two-thirds of ED visits are avoidable.

A 2019 Mount Sinai Brooklyn program reduced ED wait times by connecting low-acuity patients with care access. Usually, an emergency department segments all of its patients into a single pool, to be triaged and treated by ED providers.

However, the FastER Track program created a separate triage pool for low-acuity, non-urgent cases and treated them rapidly.

Emergency department utilization can also be decreased by boosting health resources for patients. A Detroit-based study dropped avoidable ED utilization by utilizing Medicaid community health workers to facilitate better care access and encourage reliance on outpatient care.