The Effect of Homelessness on Patient Wait Times in the Emergency Department |
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Authors: | Alexander Ayala Kyle Tegtmeyer Giancarlo Atassi Elizabeth Powell |
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Affiliation: | 1. Northwestern University Feinberg School of Medicine, Chicago, Illinois;2. Department of Pediatrics, Ann and Robert H. Lurie Children''s Hospital, Chicago, Illinois;1. Department of Emergency Medicine, Maimonides Medical Center, Brooklyn, New York;2. Department of Emergency Medicine, Mount Sinai Morningside, New York, New York;1. Department of Emergency Medicine, University of Michigan, Ann Arbor, Michigan, USA;2. Department of Pathology, University of Michigan, Ann Arbor, Michigan, USA;3. Department of Pediatrics, University of Michigan, Ann Arbor, Michigan, USA;1. Army Hospital Research and Referral, New Delhi, India;2. Formerly, Army Hospital Research and Referral, New Delhi, India;1. Department of Neurology, Johns Hopkins Hospital, Baltimore, Maryland;2. Department of Emergency Medicine, Bayview Medical Center, Baltimore, Maryland;3. Department of Emergency Medicine, Johns Hopkins Hospital, Baltimore, Maryland |
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Abstract: | BackgroundProlonged emergency department (ED) wait times could potentially lead to increased morbidity and mortality. While previous work has demonstrated disparities in wait times associated with race, information about the relationship between experiencing homelessness and ED wait times is lacking.ObjectivesThe purpose of this study was to explore the relationship between residence status (undomiciled vs. domiciled) and ED wait times. We hypothesized that being undomiciled would be associated with longer wait times.MethodsWe obtained data from the National Hospital Ambulatory Medical Care Survey from 2014 to 2017. We compared wait times in each triage category using t tests. We used multivariate linear regression to explore associations between residence status and wait times while controlling for other patient- and hospital-level variables.ResultsOn average, undomiciled patients experienced significantly longer mean ED wait times than domiciled patients (53.4 vs. 38.9 min; p < 0.0001). In the multivariate model, undomiciled patients experienced significantly different wait times by 15.5 min (p = 0.0002). Undomiciled patients experienced increasingly longer waits vs. domiciled patients for the emergent and urgent triage categories (+33.5 min, p < 0.0001, and +22.7 min, p < 0.0001, respectively).ConclusionsUndomiciled patients experience longer ED wait times when compared with domiciled patients. This disparity is not explained by undomiciled patients seeking care in the ED for minor illness, because the disparity is more pronounced for urgent and emergent triage categories. |
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Keywords: | disparity emergency department homeless population public health wait times |
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