In most U.S. emergency departments (ED), patients are admitted in an order based on both the urgency of their condition and when they arrived. But in a new study, Yale researchers found that nearly 29% of ED patients are jumped in line, with those from marginalized groups—including lower-income patients, non-white patients, and non-English speakers—more likely to be cut by others.
and highlights the need for standardized procedures.Typically, when a patient enters an emergency department—whether they walked in or were transported by ambulance—they're given an initial assessment by a triage team and assigned a score based on their medical need. That score comes from the emergency severity index, which ranges from one to five.
Patients with Medicaid as their primary insurance were more likely to be queue-jumped than those with private insurance. Similarly, patients who were Black or Hispanic were more likely to be passed over than white patients, and Spanish-speaking patients were more likely to be queue-jumped by English-speaking patients.
"That limits how well we can perform an exam," said Sangal."We have to ask sensitive questions, which is harder to do with people walking by. And doing bedside procedures in a way that maintains a patient's privacy is very difficult if not impossible." For instance, Khidir said, marginalized patients may have less access to outpatient care generally and, therefore, less information in their medical records. That could leadtriage teams to underestimate the severity of their illness. Additionally, patients who do have regular outpatient care may benefit from their provider's advocacy and get moved up the queue.
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