Racial Disparities in Door-to-Clinician Time for Cardiac Chest Pain in the Emergency Department

Area of Science:

• Emergency Medicine
• Health Equity
• Cardiology

Background:

• Timely emergency department (ED) evaluation is crucial for cardiac chest pain.
• Racial disparities in ED wait times are documented, but cardiac-specific data is limited.
• This study investigates racial and ethnic disparities in ED door-to-clinician time for cardiac chest pain.

Purpose of the Study:

• To assess racial and ethnic disparities in emergency department (ED) door-to-clinician time for patients presenting with cardiac chest pain.
• To identify specific racial or ethnic groups experiencing longer wait times for critical cardiac evaluations.
• To inform interventions aimed at reducing disparities in urgent cardiac care.

Main Methods:

• Retrospective analysis of adult ED visits for cardiac chest pain (2019-2025) at a tertiary academic hospital.
• Race/ethnicity categorized (White, Hispanic/Latino, Black, Native American, Asian, other/unknown).
• Multivariable generalized linear modeling used to assess the association between race/ethnicity and door-to-clinician time, adjusting for covariates.

Main Results:

• Overall median door-to-clinician time was 15.9 minutes among 3,925 patients.
• Unadjusted analyses showed significant differences across groups (P < .001).
• Adjusted analysis revealed Hispanic/Latino patients waited 22% longer (3.3 minutes) than White patients (P < .001); other groups did not show statistically significant adjusted differences.

Conclusions:

• Hispanic/Latino patients with cardiac chest pain experienced significantly longer ED door-to-clinician times compared to White patients.
• Findings underscore the need for targeted interventions to ensure equitable and timely emergency care for acute cardiac conditions.
• Further multisite research is recommended to validate and address these observed disparities in urgent cardiac care access.