Racial and ethnic variations in waiting times for emergency department visits related to nontraumatic dental conditions in the United States.
Racial and ethnic variations in waiting times for emergency department visits related to nontraumatic dental conditions in the United States.
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DOI：
10.14219/jada.archive.2013.0195
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发表时间：
2013-07
期刊：
影响因子：
--
通讯作者：
Szabo A
中科院分区：
文献类型：
--
作者：
Okunseri C;Okunseri E;Chilmaza CA;Harunani S;Xiang Q;Szabo A
研究已经记录了急诊科（ED）的等待时间与医疗条件的护理质量之间的关联，但对ED中非创伤性牙科疾病（NTDC）就诊等待时间的趋势和因素知之甚少。我们研究了美国急诊科NTDC就诊的等待时间和相关因素的趋势。我们分析了1997年至2007年的全国医院门诊医疗调查数据，由于缺乏等待时间信息，排除了2001年至2002年的数据。我们使用调查加权线性回归的对数转换的等待时间模型的等待时间的NTDC访问。NTDC和非NTDC访视的几何平均等待时间分别为29±1和25±0.6分钟（p<0.0001）。新界区议会的几何平均轮候时间每年增加6%，由1997年的20分钟增加至2007年的37分钟。与白人相比，西班牙裔和黑人的NTDC访视等待时间显著更长（校正倍数差异[R] =1.2，95%置信区间[CI] = 1.13-1.31）和[R] = 1.3，[CI] = 1.29-1.38）。年龄、付款人类型、就诊原因和分诊类别是等待时间的显著预测因素（1-2小时和>2- 24小时分诊类别NTDC就诊的R分别为2.3和2.4）。在全国范围内，NTDC访问的ED等待时间随着时间的推移而增加。西班牙裔（年龄≤ 33岁）和黑人在ED中等待接受NTDC治疗的时间长于白人。NTDC在急诊科就诊的等待时间延长可能会对护理质量和患者结局产生不利影响。
Studies have documented an association between wait times in emergency departments (EDs) and quality of care for medical conditions, but little is known about trends and factors associated with wait times for nontraumatic dental condition (NTDC) visits in EDs. We examined trends in wait time and associated factors for NTDC visits in EDs in the United States. We analyzed data from the National Hospital Ambulatory Medical Care survey for 1997 to 2007, with 2001-2002 excluded due to lack of wait time information. We used survey-weighted linear regression of log-transformed waiting time model for the wait time for NTDC visits. The geometric mean wait time for NTDC and non-NTDC visits was 29±1 and 25±0.6 minutes, respectively (p<0.0001). The geometric mean wait time for NTDC visits increased by 6% annually and from 20 minutes in 1997 to 37 minutes in 2007. Compared to Whites, Hispanics and Blacks had significantly longer wait times for NTDC visits (adjusted fold-difference [R] =1.2, 95% confidence interval [CI] = 1.13-1.31) and [R] = 1.3, [CI] = 1.29-1.38). Age, payer type, reason for visit and triaged category were significant predictors of wait time (R=2.3 and 2.4 for NTDC visits in triage category of 1-2 hours and >2-24hours respectively). Nationally, wait times in EDs for NTDC visits increased over time. Hispanics (aged ≤ 33years old) and Blacks waited longer to receive care for NTDCs in EDs than Whites. Prolonged wait times for NTDC visits in emergency departments could adversely impact quality of care and patient outcomes.
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