Hispanic adults experience ’unwarranted delays’ in ED for chest pain
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Hispanic adults presenting with chest pain may experience up to a 28-minute delay in triage and disposition from the ED when compared with patients from other backgrounds, possibly due to undocumented status, researchers reported.
“This study is a calling for health professionals to advocate and increase awareness of the health disparities faced not only by the Hispanic community but also other minorities,” Katiria Pintor Jimenez, MD, an internal medicine resident at Morehouse School of Medicine in Atlanta, told Healio. “Health disparities faced by these communities may contribute to delays in health care access and, eventually, affect the wellbeing of patients. Specifically, our findings suggests that Hispanic people with chest pain may experience unwarranted delays in the ED in receiving overall medical care in the hospital.”
Jimenez and colleagues analyzed electronic medical records data from more than 11,000 medical records of people presenting to the ED at Grady Memorial Hospital in Atlanta, a large safety net hospital, between January and December 2020 with a chief symptom of chest pain. Researchers performed bivariate analyses to identify the relationship between Hispanic ethnicity and ED disposition.
The findings were presented at the American Heart Association Quality of Care and Outcomes Research Scientific Sessions.
Hispanic patients who presented with chest pain represented 4.78% of patients and tended to be younger (mean age, 43 years vs. 49 years) and had lower BP (mean, 128.8/77.8 mm Hg vs. 134.5/81.5 mm Hg) compared with patients from other races and ethnicities; however, Hispanic patients were nearly three times more likely to be uninsured (OR = 2.93; 95% CI, 2.44-3.51; P < .05). Hispanic women were 58% more likely to present with chest pain vs. Hispanic men (OR = 1.58; 95% CI, 1.32-1.88; P < .05).
Although Hispanic patients were admitted more often compared with other races and ethnicities (17.74 vs. 16.79%), overall disposition from the ED, defined as admittance to inpatient, observation and discharge, was 1.39 times longer for Hispanic individuals (99 minutes vs. 71 minutes; P < .05). Disposition for admitted Hispanic patients took 1.98 times longer, with mean time of 86 minutes vs. 43.5 minutes compared with other groups (P < .05).
“Educating health care professionals in cultural competency is of paramount importance to address and reduce health disparities for Hispanic people,” Pintor Jimenez said in a press release. “Our team’s next steps are to implement a focused educational intervention for medical residents to confirm that physician-driven interventions can increase awareness and promote the elimination of racial and ethnic health disparities in the Hispanic population.”
The research adds to a growing body of evidence that suggest ED wait times for chest pain vary significantly by sex and race. As Healio previously reported, a recent analysis published in the Journal of the American Heart Association found that young women and people from historically underrepresented groups with chest pain waited longer to be seen by physicians independent of clinical features, whereas women were independently less likely to be admitted when presenting with chest pain.
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Jimenez KP, et al. Presentation 225. Presented at: American Heart Association Quality of Care and Outcomes Research Scientific Sessions; May 13-14, 2022; Reston, Va. (hybrid meeting).
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