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A Novel Method for Involving Women of Color at High Risk for Preterm Birth in Research Priority Setting

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Racial and Language Disparities in Pediatric Emergency Department Triage.

Peter Metzger¹, Leyla Allum², Erin Sullivan³

¹From the Department of Pediatrics, University of Washington.

Pediatric Emergency Care

|May 19, 2021

Summary

Non-White children received lower emergency department triage scores than White children, indicating potential bias. Further research is needed to understand if this reflects bias or differences in healthcare utilization.

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Area of Science:

Pediatric Emergency Medicine
Health Equity
Clinical Triage Systems

Background:

Racial and linguistic disparities in healthcare access and outcomes are well-documented.
Emergency department (ED) triage scores are critical for prioritizing patient care based on illness severity.

Purpose of the Study:

To investigate the influence of race and language on ED triage scores in pediatric patients.
To determine if non-White and non-English-speaking children receive lower acuity scores compared to their White and English-speaking counterparts, controlling for illness severity.

Main Methods:

Retrospective cohort study of pediatric patients (0-17 years) in a single ED.
Illness severity assessed using a modified Pediatric Early Warning Score.
Multivariate logistic regression analyzed the association between race/language and Emergency Severity Index (ESI) scores.

Main Results:

Non-White patients had significantly lower odds of receiving high-acuity triage scores (ESI 2 or 3) and higher odds of receiving low-acuity scores (ESI 5) compared to White patients.
No consistent disparities in ESI scores were observed between English- and non-English-speaking patients.
The study included 10,815 visits from 8,928 pediatric patients.

Conclusions:

The study confirms that non-White pediatric patients are assigned lower triage scores than White patients.
A more refined triage tool is necessary to accurately account for illness severity and elucidate whether observed disparities stem from triage bias or differential ED utilization patterns.