Related Experiment Video
Updated: Aug 5, 2026
E-Patient Counseling Trial (E-PACO): Computer Based Education versus Nurse Counseling for Patients to Prepare for Colonoscopy
Published on: August 1, 2019
Association of Patient Language and Crowding with Wait Times at an Academic Medical Center Emergency Department
Brandon W Yan1,2, Elizabeth Kwan3, Nader Najafi4,5
1Department of Medicine, UCSF School of Medicine, San Francisco, CA, USA. Brandon.Yan@ucsf.edu.
Background:
Emergency departments (ED) provide timely care for acute conditions and serve as a vital safety net. Longer ED wait times are associated with worse health outcomes, but differences in ED wait times by patient language remain understudied.
Objective:
Examine differences in ED wait times between English and non-English language patients and its association with ED crowding.
Design:
Retrospective cohort study of ED visits at an academic medical center in 2023 and 2024.
Participants:
73,420 ED visits among adult patients not triaged to the highest acuity categories.
Main Measures:
Wait times from triage to provider assignment by patient primary language were assessed via unadjusted analyses and generalized linear models adjusting for demographic, temporal, and system factors as well as patient comorbidities and chief complaint. Language was then interacted with ED census to assess for effect modification from ED crowding. Secondary outcomes were time from provider assignment to ED disposition and rates of left without being seen (LWBS).
Key Results:
Patients with a primary non-English language waited on average 6.5 min (p < 0.001) or 8.4% longer than English-primary patients for an ED provider-a difference that persisted after statistical adjustment (6.6 min, p < 0.001). Cantonese, Spanish, Russian, and Toishanese language patients experienced statistically longer wait times than English language patients. With ED census, each 10 additional patients in the ED were associated with an adjusted 2.3 min (p = 0.02) longer differential wait time for non-English language patients. Despite these differences, rates of LWBS were significantly lower for non-English language patients in both unadjusted and adjusted analyses (p < 0.001).
Conclusions:
Longer ED wait times for patients with a primary non-English language reflect a health inequity affecting a disadvantaged population. The degree of disparity widened as ED census increased. Health system and policy attention is needed to address ED crowding and other factors that could contribute to this disparity.
More Related Videos
09:52Setting Up a Stroke Team Algorithm and Conducting Simulation-based Training in the Emergency Department - A Practical Guide
Published on: January 15, 2017
06:16Signal Acquisition, Score Interpretation, and Economics of a Non-Invasive Point-of-Care Test for Coronary Artery Disease
Published on: August 9, 2024
Related Concept Videos
01:21Barriers to Effective Communication II
Cultural barriers:
Differences in values, beliefs, religion, knowledge, and tradition can significantly impact communication. Awareness of nonverbal cues is critical, especially when conversing with a patient from a different culture. What appears appropriate in one culture may be inappropriate in another.
Semantic barriers:
As a result of their tendency to use...
01:26Types of Reports III: Telephone and Verbal Reports
Here's an overview of each type:
Telephone Orders
01:26Methods of Documentation II: POMR
01:15Methods of Documentation VI: Case Management Model
For example, a patient with a chronic illness...
01:30Methods of Documentation VII: EMR
01:14SBAR II: Application of SBAR
SBAR Report from a Nurse to a Health Care Provider
S: "Hello, Dr. Smith. This is Jane, RN, from the Med Surg unit. I am calling to tell you about Ms. White in Room 210, who is experiencing increased pain and redness at her incision site. Her recent...