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Area of Science:

  • Emergency Medicine
  • Health Equity
  • Clinical Triage

Background:

  • Racial disparities exist in healthcare access and outcomes.
  • Black and Hispanic patients often receive lower triage scores than White patients.
  • Subjective complaints may be more susceptible to bias in triage decisions.

Purpose of the Study:

  • To investigate if racial disparities in triage scores are more pronounced for patients with subjective complaints.
  • To analyze triage assignment for Black and Hispanic patients compared to White patients.
  • To identify potential biases in emergency department (ED) triage processes.

Main Methods:

  • Retrospective analysis of adult ED visits (2016-2019).
  • Categorization of chief complaints: subjective, observed, numeric, protocolized.
  • Logistic regression models controlling for demographic and arrival factors.

Main Results:

  • Black and Hispanic patients were less likely to be assigned high-acuity triage scores (aOR < 1).
  • This disparity was greater for subjective complaints like chest pain, dyspnea, and pain.
  • Patients requiring high-acuity care were disproportionately initially triaged to lower acuity for subjective complaints.

Conclusions:

  • Black and Hispanic adults, particularly those with subjective complaints, face disproportionate lower-acuity triage.
  • This suggests potential bias in assessing subjective symptoms during ED triage.
  • Further research is needed to address and mitigate bias in triage for subjective complaints.