{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T07:18:52Z","timestamp":1778656732285,"version":"3.51.4"},"reference-count":13,"publisher":"California Digital Library (CDL)","issue":"5","license":[{"start":{"date-parts":[[2022,8,28]],"date-time":"2022-08-28T00:00:00Z","timestamp":1661644800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["WestJEM"],"abstract":"<jats:p>Introduction: Emergency department (ED) boarding, the process of holding patients in the ED due to a lack of inpatient beds after the decision is made to admit, has profound consequences. Increased ED boarding times are associated with adverse patient outcomes, including increased mortality. While previous studies have demonstrated racial disparities with regard to ED boarding, current literature lacks insight into discrepancies that may exist among other demographic groups as it pertains to ED boarding. We sought to review ED boarding times differentiated by demographic characteristics.\n\nMethods: We conducted a retrospective review of all ED admissions from an academic ED in the Southeast from April\u2013September 2019. The primary outcome assessed was boarding time, defined as time from decision to admit to ED departure.\u00a0Patient demographic data including race, gender, and age were collected and analyzed. We performed descriptive statistics and chi-square analyses. \n\nResults: The study population included 17,606 patients with a mean age of 56.3. Nearly half (49.8%) of the patients were female. Additionally, 43.8% of patients were Black and 48.6% White. For all admissions, there was no difference in mean boarding time among Black and White patients (5.2 \u00b1 8.8 vs 5.2 \u00b1 8.2 hours, P = 0.11). Among Emergency Severity Index (ESI) level I admissions, Black patients boarded longer than White patients (4.1 \u00b1 0.3 vs 2.7 \u00b1 0.3 hours, P = 0.009). Black patients also boarded significantly longer than White patients for psychiatric admissions (22.7 \u00b1 23.7 vs 18.5 \u00b1 19.4 hours, P &lt;0.05). For all admissions, males boarded longer than females (5.5 \u00b1 8.5 vs 4.9 \u00b1 8.2 hours, P &lt;.0001). Patients older than 75 boarded for less time (3.8 \u00b1 6.2 hours) compared to younger groups (15-24: 6.4 \u00b1 10.8 hours; 25-44: 6.6 \u00b1 10.8; 45-64: 5.0 \u00b1 7.6; and 64-75: 4.7 \u00b1 6.7; all P &lt;.05). \n\nConclusion: This analysis demonstrated significant differences in ED boarding times between races among psychiatric and ESI I admissions, gender, and age.\u00a0This data provides insight into differences in ED boarding times among demographic groups and provides a focal point for examining possible factors contributing to the observed differences.<\/jats:p>","DOI":"10.5811\/westjem.2022.5.55703","type":"journal-article","created":{"date-parts":[[2022,9,26]],"date-time":"2022-09-26T02:45:24Z","timestamp":1664160324000},"page":"644-649","source":"Crossref","is-referenced-by-count":8,"title":["Race and Other Disparate Demographic Variables Identified Among Emergency Department Boarders"],"prefix":"10.5811","volume":"23","author":[{"given":"Robert","family":"Ruffo","sequence":"first","affiliation":[{"name":"University of Alabama at Birmingham Heersink School of Medicine, Department of Emergency Medicine, Birmingham, Alabama"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erin","family":"Shufflebarger","sequence":"additional","affiliation":[{"name":"University of Alabama at Birmingham Heersink School of Medicine, Department of Emergency Medicine, Birmingham, Alabama"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James","family":"Booth","sequence":"additional","affiliation":[{"name":"University of Alabama at Birmingham Heersink School of Medicine, Department of Emergency Medicine, Birmingham, Alabama"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lauren","family":"Walter","sequence":"additional","affiliation":[{"name":"University of Alabama at Birmingham Heersink School of Medicine, Department of Emergency Medicine, Birmingham, Alabama"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"29705","published-online":{"date-parts":[[2022,8,28]]},"reference":[{"key":"ref0","unstructured":"AHA. American Hospital Association. Fast facts on U.S. hospitals, 2021. 2021. Available at: https:\/\/www.aha.org\/statistics\/fast-facts-us-hospitals. Accessed December 5, 2021."},{"key":"ref1","unstructured":"U.S. Department of Health and Human Services. Health, United States, 2012. 2013. Available at: https:\/\/www.cdc.gov\/nchs\/data\/hus\/hus12.pdf. Accessed December 5, 2021."},{"key":"ref2","doi-asserted-by":"publisher","unstructured":"Singer AJ, Viccellio AW, Thode HC, et al. Association between length of emergency department boarding, mortality and length of hospital stay. Ann Emerg Med. 2009;54(3):1325-7.","DOI":"10.1016\/j.annemergmed.2009.06.464"},{"key":"ref3","doi-asserted-by":"publisher","unstructured":"Sri-On J, Chang Y, Curley DP, et al. Boarding is associated with higher rates of medication delays and adverse events but fewer laboratory-related delays. Am J Emerg Med. 2014;32(9):1033-6.","DOI":"10.1016\/j.ajem.2014.06.001"},{"key":"ref4","doi-asserted-by":"publisher","unstructured":"Coil CJ, Flood JD, Belyeu BM, et al. The effect of emergency department boarding on\u00a0order\u00a0completion. Ann Emerg Med. 2016;67(6):730-6.","DOI":"10.1016\/j.annemergmed.2015.09.018"},{"key":"ref5","doi-asserted-by":"publisher","unstructured":"Ramsey Z, Palter J, Hardwick J, et al. Decreased nursing staffing adversely affects emergency department throughput metrics. West J Emerg Med. 2018;19(3):496-500.","DOI":"10.5811\/westjem.2018.1.36327"},{"key":"ref6","doi-asserted-by":"publisher","unstructured":"Pines JM, Russell Localio A, Hollander JE. Racial disparities in emergency department length of stay for admitted patients in the United States. Acad Emerg Med. 2009;16(5):403-10.","DOI":"10.1111\/j.1553-2712.2009.00381.x"},{"key":"ref7","doi-asserted-by":"crossref","unstructured":"Nicks BA, Manthey DM. The impact of psychiatric patient boarding in emergency departments. Emerg Med Int. 2012;2012:1-5.","DOI":"10.1155\/2012\/360308"},{"key":"ref8","doi-asserted-by":"publisher","unstructured":"Slade EP, Dixon LB, Semmel S. Trends in the duration of emergency department visits, 2001\u20132006. Psychiatr Serv. 2010;61(9):878-84.","DOI":"10.1176\/ps.2010.61.9.878"},{"key":"ref9","unstructured":"Owens PL, Fingar KR, McDermott KW, et. al. Inpatient stays involving mental and substance use disorders, 2016: Statistical brief #249. Healthcare Cost and Utilization Project (HCUP) Statistical Briefs. 2019. Available at: https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/31063293. Accessed November 9, 2021."},{"key":"ref10","unstructured":"Emergency severity index (ESI): a triage tool for emergency department. AHRQ. Available at: https:\/\/www.ahrq.gov\/patient-safety\/settings\/emergency-dept\/esi.html. Accessed November 15, 2021."},{"key":"ref11","doi-asserted-by":"publisher","unstructured":"Pearlmutter MD, Dwyer KH, Burke LG, et al. Analysis of emergency department length of stay for mental health patients at ten Massachusetts emergency departments. Ann Emerg Med. 2017;70(2):193-202.","DOI":"10.1016\/j.annemergmed.2016.10.005"},{"key":"ref12","doi-asserted-by":"publisher","unstructured":"Salehi L, Phalpher P, Valani R, et al. Emergency department boarding: a descriptive analysis and measurement of impact on outcomes. CJEM. 2018;20(6):929-37.","DOI":"10.1017\/cem.2018.18"}],"container-title":["Western Journal of Emergency Medicine"],"original-title":[],"deposited":{"date-parts":[[2022,9,26]],"date-time":"2022-09-26T02:45:31Z","timestamp":1664160331000},"score":1,"resource":{"primary":{"URL":"https:\/\/escholarship.org\/uc\/item\/9g61x95x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,8,28]]},"references-count":13,"issue-title":["Western Journal Of Emergency Medicine"],"journal-issue":{"issue":"5","published-online":{"date-parts":[[2022,9,20]]}},"URL":"https:\/\/doi.org\/10.5811\/westjem.2022.5.55703","relation":{},"ISSN":["1936-900X"],"issn-type":[{"value":"1936-900X","type":"print"}],"subject":[],"published":{"date-parts":[[2022,8,28]]}}}