Racial Disparities in Emergency Department Wait Times for Patients Presenting with Chest Pain and Shortness of Breath: An Analysis of the National Hospital Ambulatory Medical Care Survey (NHAMCS) 2019-2021

Introduction: Extended Emergency Department (ED) wait times are associated with adverse health outcomes, including insufficient treatment rates, admissions, and mortality, especially in patients with chest pain and dyspnea. Given people of racial/ethnic minorities disproportionately experience health disparities, identifying barriers to care in the ED may impact already vulnerable populations, thus improving health equity. Therefore, our primary objective was to assess differences in ED wait times by race for patients presenting with chest pain and dyspnea using the National Hospital Ambulatory Medical Care Survey (NHAMCS) data.

Methods: Using survey weights provided by NHAMCS, we determined national estimates for ED wait times for 2019-2021 by ED triage level for patients presenting with chest pain and dyspnea. We constructed a linear regression to assess the difference in wait times by race/ethnicity. We applied bootstrapping (2000 replications) to account for unbalanced samples between racial/ethnic groupings and controlled for race, sex, age, triage level, and urbanicity.

Results: All racial/ethnic minority groups experienced longer wait times than White patients except for Other/Multiracial. In our linear regression analysis, Black patients (34.66 minutes; SE = 2.95 ) experienced a statistically significant increase in ED wait times compared to White patients (28.09 minutes; SE = 1), according to the binary model.

Conclusion: Our study demonstrates that racial disparities in the ED persist, given the increased wait times for minority patients. Racial disparities in the ED are complex; therefore, expanding research to identify strategies to further mitigate contributing factors are crucial to reaching health equity.