Percentage of US Emergency Department Patients Seen Within the Recommended Triage Time

摘要: The Institute of Medicine has described the state American emergency departments (EDs) as a “growing national crisis.”1(pXIII) A notable symptom this crisis is increasingly long time that patients wait to see an ED health care provider. In 1997, waited median 22 minutes after they arrived in be evaluated by physician.2 By 2004, were waiting 30 minutes, 36% increase.2 Prolonged decreases patient satisfaction,3-5 limits access,6 increases number who leave before being seen,7 and associated with clinically significant delays for pneumonia, cardiac symptoms, abdominal pain.8-10 Consequently, 2008, National Quality Forum recommended seen provider 1 10 new quality metrics care.11 Wait itself imperfect measure timeliness because appropriateness given depends on patient’s acuity illness. Less acutely ill can safely longer. Reports have generally not considered clinical context, except occasionally identify most separate analysis.2 Because average level decreased during past decade,2,12 reported aggregate been difficult interpret. Instead, US Government Accountability Office recently that, 2006, 50.4% emergent visits had times exceeded frame at triage.13 This approach advantage accounting triage acuity; however, we few data regarding trends measure. Given decrease illness patients, it important know whether percentage longer than changed significantly each over time. Furthermore, racial/ethnic disparities exist2,14 persisted or even worsened time2,15 other measures timely care, such length stay, investigate same true fashion. Accordingly, study, used from Hospital Ambulatory Medical Care Survey (NHAMCS) examine within target 1997 these changes affect differently according levels. We also investigated blacks Hispanics uninsured are disproportionately unlikely their times, any changing