Journal of Clinical Gastroenterology

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October 2023 - Volume 57 - Issue 9

  • Ronnie Fass, MD, FACG
  • 0192-0790
  • 1539-2031
  • 10 issues / year
  • Gastroenterology & Hepatology 61/93
  • 2.9
In "Disparities in Emergency Department Waiting Times for Acute Gastrointestinal Bleeding​," the authors aim to assess waiting time across different racial groups to determine whether racial disparities exist in patients presenting with gastrointestinal bleeding to US emergency departments.  The authors use the National Hospital Ambulatory Medical Care Survey (NHAMCS) from 2009-2018 to compare waiting time of patients with GI bleed across different racial/ethnic groups. A multinomial logistic regression was applied to adjust the outcomes for possible confounders. The authors assess the trend of the waiting time over the study interval and compared the waiting time between the first (2009) and last year (2018) of the study interval. They note that there were an estimated 7.8 million ED visits for GI bleed between 2009 and 2018. The mean waiting time ranged from 48 minutes for non-Hispanic white patients to 68 minutes for African American patients. After adjusting for gender, age, geographic regions, payment type, type of GI bleeding, and triage status, multinomial logistic regression showed significantly higher waiting time for African American patients than non-Hispanic white (OR 1.01, P=0.03) patients. The overall trend showed a significant decrease in the mean waiting time (P-value<0.001). In 2009, Black patients waited 69 minutes longer than non-Hispanic white patients (P Value<0.001), while in 2018, this gap was erased with no statistically significant difference (P-value=0.26). This study suggests that racial disparities among patients presenting with GI bleed are present in US EDs. Black patients waited longer for their first visits. However, the good news from this study is that over time, ED wait time has decreased, leading to a decline in the observed racial disparity. However, confirmatory studies using a prospective design and different databases are needed.

Ronnie Fass, MD​​

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