Black Patients with Mental Health and Substance-Related Disorders Experience Longer Wait Times in the Emergency Department

Emergency Department (ED) crowding has been identified as a public health crisis in the US, with ED utilization increasing at a faster rate among patients with mental health and substance-related disorders than overall ED utilization. This cross-sectional study examined ED wait times among this population and evaluated the impact of race/ethnicity, insurance type, and geographical location on identified disparities.

• Of 6534 ED visits, the majority were made by non-Hispanic whites (66%), followed by non-Hispanic blacks (19%) and other non-Hispanic races (3%).
• 39% of all ED visits were substance use-related.
• Private insurance, Medicare, and Medicaid beneficiaries accounted for 22%, 18%, and 25% of ED visits respectively; 23% of individuals did not have health insurance.
• After adjusting for patient and hospital-level factors, ED wait time was 23% longer for non-Hispanic blacks compared with non-Hispanic whites.
• ED wait time did not differ by insurance type or geographic location.

Comments: Racial disparities were observed in this study, with ED wait times found to be significantly longer for non-Hispanic black patients with mental health and substance-related disorders compared with non-Hispanic whites with similar disorders. These findings highlight the need for urgent corrective ED, community-based and culturally competent interventions to both improve care for this patient population and help address ED overcrowding.

Seonaid Nolan, MD

Reference: Opoku ST, Apenteng BA, Akowuah EA, Bhuyan S. Disparities in emergency department wait time among patients with mental health and substance-related disorders. J Behav Health Serv Res. 2017 [Epub ahead of print]. doi: 10.1007/s11414-017-9565-8.