Racial/Ethnic differences in emergency department triage assignment among visits for substance use.

<h4>Background</h4>The opioid/substance use disorder (SUD) epidemic in the United States has become a public health crisis. Stigma by health care workers towards patients with SUD has been identified as a barrier to treatment. Additionally, racial inequities in wait times and service pro...

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Main Authors: Samantha Goldfarb, Natalie Dix, Austin Spitz, Katelyn Graves, Megan Deichen Hansen, Shermeeka Hogans-Mathews, Jessica Day, Jeffrey Harman
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2025-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0329376
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Summary:<h4>Background</h4>The opioid/substance use disorder (SUD) epidemic in the United States has become a public health crisis. Stigma by health care workers towards patients with SUD has been identified as a barrier to treatment. Additionally, racial inequities in wait times and service provision have been found in Emergency Departments (EDs).<h4>Objective</h4>The purpose of this study was to examine the racial/ethnic differences in severity of ED triage assignment among visits for SUD.<h4>Methods</h4>This retrospective study utilized pooled data from the National Hospital Ambulatory Medical Care Survey (NHAMCS) from 2016-20. The dependent variable was the recorded triage level for patients with SUD. The independent variable was patient race/ethnicity. Analyses controlled for variables such as age, sex, and arrival by ambulance. Differences in triage level by race/ethnicity among visits by patients with SUD was assessed via multivariable logistic regression models.<h4>Results</h4>Of the reported 788 SUD-specific ED visits from patients with SUD, 56.0% were non-Hispanic White, 28.6% were non-Hispanic Black, 12.9% were Hispanic, and 2.5% were of another race. Visits by Black patients with SUD had 53% lower odds of being assigned to an immediate/emergent triage level compared to visits by White patients with SUD (OR=0.47, p = .025).<h4>Conclusion</h4>We found that visits by Black patients with SUD were associated with lower odds of receiving an immediate/emergent triage assignment compared to visits by White patients with SUD, after adjusting for confounding variables. Our results suggest potential dual stigma in ED care of being Black and having a substance use disorder.
ISSN:1932-6203