Evidence map›Paper›PMID 40178794›Full record

ArticleHealth services research2025

Clocking Injustice: Racial Disparities in Specialty Wait Times.

Daniel A Asfaw, Sarah H Gordon, Michael Anne Kyle, Kevin N Griffith

Abstract read
In one paragraph

Article in Health services research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Daniel A AsfawDepartment of Health Law, Policy and Management, Boston University School of Public Health, Boston, Massachusetts, USA.ORCID https://orcid.org/0000-0001-8986-8575
Sarah H GordonDepartment of Health Law, Policy and Management, Boston University School of Public Health, Boston, Massachusetts, USA.ORCID https://orcid.org/0000-0003-4743-2014
Michael Anne KyleDepartment of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA.
Kevin N GriffithPartnered Evidence-based Policy Research Center, VA Boston Healthcare System, Jamaica Plain, Massachusetts, USA.ORCID https://orcid.org/0000-0002-8304-8602

Funding

Training in Oncology Population Sciences (TOPS)T32CA092203 · NCI · DANA-FARBER CANCER INST · PI Nancy L Keating, JENNIFER W MACK · 2018 to 2026
$3.7M
Patient Administrative Burden in Cancer Care DeliveryR00CA277367 · NCI · UNIVERSITY OF PENNSYLVANIA · PI Michael Anne Kyle · 2024 to 2026
$747k
Patient Administrative Burden in Cancer Care DeliveryK99CA277367 · NCI · HARVARD MEDICAL SCHOOL · PI KYLE, MICHAEL ANNE · 2023 to 2024
$296k
AHRQ HHS K12 HS026395AHRQ HHS K12HS026395CCR NIH HHS 5T32CA092203NCI NIH HHS K99 CA277367NCI NIH HHS R00 CA277367NCI NIH HHS T32 CA092203VA PEC 16-001
6 · The paper itself

Abstract

objectiveTimely access to care is associated with improved morbidity, mortality, and quality of life, making disparate access to specialty care a potential contributor to racial inequities in health outcomes. In this nationwide analysis, we quantified specialty care waits by race and ethnicity and identified potential drivers of observed disparities. STUDY SETTING AND

designThe U.S. Veterans Health Administration (VHA) provides care directly through its network of 170 medical centers and 1,193 associated outpatient clinics. In addition, the VHA pays for millions of appointments with community-based specialists each year. We used multivariate regression models and Kitagawa-Oaxaca-Blinder decomposition to identify drivers of disparities between White and minoritized veterans. DATA SOURCES AND ANALYTIC SAMPLE: We used administrative data to identify patients referred to either VHA or community specialists during 2018-2022 for the 10 highest-volume specialties: cardiology, dermatology, otorhinolaryngology, gastrointestinal endoscopy/gastroenterology, mental health, ophthalmology, orthopedics, podiatry, physical therapy, and urology. PRINCIPAL

findingsOur sample included 6,619,517 referrals to VHA specialists and 3,753,657 referrals to community care. Black patients had the longest mean waits for VHA care (40.0 days, SD = 40.3) followed by American Indian/Alaska Native (38.6 days, SD = 40.0), Hispanic (38.4 days, SD = 38.4), Asian/Pacific Islander (38.1 days, SD = 38.0), and White patients (37.1 days, SD = 39.5). For community care, Black patients had the longest mean waits (52.9 days, SD = 49.3) followed by Asian/Pacific Islander (46.8 days, SD 43.1), American Indian/Alaska Native (46.5 days, SD = 42.1), White (45.1 days, SD = 41.7), and Hispanic patients (42.0 days, SD = 37.6). Disparities were primarily attributable to group-level differences in the distribution of facilities from which patients were referred and specialty mix.

conclusionsCompared to non-Hispanic Whites, minoritized patients tended to receive referrals from facilities that had longer wait times. Policies designed to increase quality and health care supply in under-resourced areas may be an important strategy in closing racial inequities in timely access to care.

Indexed as

EthnicityHealthcare DisparitiesHealth Services AccessibilityRacial GroupsSpecializationWaiting ListsAdultAgedFemaleHumansMaleMedicineMiddle AgedReferral and ConsultationUnited StatesUnited States Department of Veterans Affairsaccess to carehealth equityspecialty careveteranswait times

Identifiers

PMID40178794
PMCPMC12461106

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.