ArticleThe American journal of emergency medicine2024
Patient sex, racial and ethnic disparities in emergency department triage: A multi-site retrospective study.
Article in The American journal of emergency medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed.
- An Evidence-Based Framework for Patient-Facing Artificial Intelligence Integration in the Emergency Department.Journal of the American College of Emergency Physicians open · 2026Article
- Beyond a Diagnosis: A Qualitative Study Exploring Patient and Caregiver Expectations About Emergency Department Visits Amid Uncertainty.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2026Article
- Is Artificial Intelligence Ready for Emergency Department Triage? A Retrospective Evaluation of Multiple Large Language Models in 39,375 Patients at a University Emergency Department.Journal of clinical medicine · 2026Article
- Development and Temporal Validation of a Logistic Regression-Based Risk Score for Identifying Life-Threatening Chest Pain at Emergency Department Triage: A Retrospective Cohort Study.Vascular health and risk management · 2026Observational
- Patterns in Duration of Emergency Department Boarding and Variation by Sociodemographic Factors.The western journal of emergency medicine · 2025Article
- Variation in Emergency Department Physician Admitting Practices and Subsequent Mortality.JAMA internal medicine · 2025Article
- Health disparities influence peripheral venous access insertion time in the emergency department: An observational study.PloS one · 2025Observational
- Estimation of racial and language disparities in pediatric emergency department triage using statistical modeling and natural language processing.Journal of the American Medical Informatics Association : JAMIA · 2024Article
- Identifying Patient Subpopulations with Significant Race-Sex Differences in Emergency Department Disposition Decisions.Health services insights · 2024Article
Corrections and comments
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Authors and funding
10 authors.
Funding
Abstract
objectivesThere is limited evidence on sex, racial, and ethnic disparities in Emergency Department (ED) triage across diverse settings. We evaluated differences in the assignment of Emergency Severity Index (ESI) by patient sex and race/ethnicity, accounting for age, clinical factors, and ED operating conditions.
methodsWe conducted a multi-site retrospective study of adult patients presenting to high-volume EDs from January 2019-February 2020. Patient-level data were obtained and analyzed from three EDs (academic, metropolitan community, and rural community) affiliated with a large health system in the Southeastern United States. For the study outcome, ESI levels were grouped into three categories: 1-2 (highest acuity), 3, and 4-5 (lowest acuity). Multinomial logistic regression was used to compare ESI categories by patient race/ethnicity and sex jointly (referent = White males), adjusted for patient age, insurance status, ED arrival mode, chief complaint category, comorbidity score, time of day, day of week, and average ED wait time.
resultsWe identified 186,840 eligible ED visits with 56,417 from the academic ED, 69,698 from the metropolitan community ED, and 60,725 from the rural community ED. Patient cohorts between EDs varied by patient age, race/ethnicity, and insurance status. The majority of patients were assigned ESI 3 in the academic and metropolitan community EDs (61% and 62%, respectively) whereas 47% were assigned ESI 3 in the rural community ED. In adjusted analyses, White females were less likely to be assigned ESI 1-2 compared to White males although both groups were roughly comparable in the assignment of ESI 4-5. Non-White and Hispanic females were generally least likely to be assigned ESI 1-2 in all EDs. Interactions between ED wait time and race/ethnicity-sex were not statistically significant.
conclusionsThis retrospective study of adult ED patients revealed sex and race/ethnicity-based differences in ESI assignment, after accounting for age, clinical factors, and ED operating conditions. These disparities persisted across three different large EDs, highlighting the need for ongoing research to address inequities in ED triage decision-making and associated patient-centered outcomes.
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