Assessing experiences of racism among Black and White patients in the emergency department
Abstract Objective The objective of this study was to investigate the differences in patient‐reported experiences related to emergency department (ED) care using a post‐discharge text messaging survey. Methods This was a prospective cohort study of patients discharged from the ED using an automated...
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| Format: | Article |
| Language: | English |
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Elsevier
2022-12-01
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| Series: | Journal of the American College of Emergency Physicians Open |
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| Online Access: | https://doi.org/10.1002/emp2.12870 |
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| author | Anish K. Agarwal Charlotte Sagan Rachel Gonzales Sally Nijim Raina M. Merchant David A. Asch Eugenia C. South |
| author_facet | Anish K. Agarwal Charlotte Sagan Rachel Gonzales Sally Nijim Raina M. Merchant David A. Asch Eugenia C. South |
| author_sort | Anish K. Agarwal |
| collection | DOAJ |
| description | Abstract Objective The objective of this study was to investigate the differences in patient‐reported experiences related to emergency department (ED) care using a post‐discharge text messaging survey. Methods This was a prospective cohort study of patients discharged from the ED using an automated text messaging platform to assess patient experience and impact of race on ED care. The study was conducted for 7 weeks between August 6 and September 24, 2021. Participants included adults (aged ≥18 years) discharged from 2 urban, academic EDs with an active mobile phone number in the electronic health record. The primary outcome of interest was patient‐reported impact of race on overall rating of ED care. Secondary outcomes included overall satisfaction with care and perceived impact of race on components of care, including respect, communication, and quality of care. A 6‐point Likert scale was used, and chi‐square and Wilcoxon rank sum tests were used to analyze responses. Results A total of 590 (14%) discharged patients consented, and 462 patients completed the entire survey; the mean age was 43 years (SD 17.3); 67% were women, and 60.0% were Black. Black patients reported a higher overall rating of ED care (median 5 [3, 5]; P = 0.013). Proportionately, when compared with White patients, more Black patients reported that race negatively impacted the rating of care (10.8% vs 1.4%; P = 0.002). More than a quarter of Black patients (27.4%) reported race highly impacting being treated with respect (P = 0.024), and 22.4% reported a high impact on quality of service (P = 0.003) when compared with White patients. Conclusion Health systems lack methods that specifically identify patient experiences of racism. We demonstrate the feasibility of using text messaging to collect patient‐reported experiences of racism. For a significant number of Black patients, race negatively impacted their care, including communication, quality, and respect. |
| format | Article |
| id | doaj-art-e92e83d5237c4486843bfb1e40be0baa |
| institution | OA Journals |
| issn | 2688-1152 |
| language | English |
| publishDate | 2022-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of the American College of Emergency Physicians Open |
| spelling | doaj-art-e92e83d5237c4486843bfb1e40be0baa2025-08-20T02:22:14ZengElsevierJournal of the American College of Emergency Physicians Open2688-11522022-12-0136n/an/a10.1002/emp2.12870Assessing experiences of racism among Black and White patients in the emergency departmentAnish K. Agarwal0Charlotte Sagan1Rachel Gonzales2Sally Nijim3Raina M. Merchant4David A. Asch5Eugenia C. South6Department of Emergency Medicine Perelman School of Medicine University of Pennsylvania Philadelphia Pennsylvania USADepartment of Emergency Medicine Perelman School of Medicine University of Pennsylvania Philadelphia Pennsylvania USADepartment of Emergency Medicine Perelman School of Medicine University of Pennsylvania Philadelphia Pennsylvania USAPerelman School of Medicine University of Pennsylvania Philadelphia Pennsylvania USADepartment of Emergency Medicine Perelman School of Medicine University of Pennsylvania Philadelphia Pennsylvania USALeonard Davis Institute of Health Economics University of Pennsylvania Philadelphia Pennsylvania USADepartment of Emergency Medicine Perelman School of Medicine University of Pennsylvania Philadelphia Pennsylvania USAAbstract Objective The objective of this study was to investigate the differences in patient‐reported experiences related to emergency department (ED) care using a post‐discharge text messaging survey. Methods This was a prospective cohort study of patients discharged from the ED using an automated text messaging platform to assess patient experience and impact of race on ED care. The study was conducted for 7 weeks between August 6 and September 24, 2021. Participants included adults (aged ≥18 years) discharged from 2 urban, academic EDs with an active mobile phone number in the electronic health record. The primary outcome of interest was patient‐reported impact of race on overall rating of ED care. Secondary outcomes included overall satisfaction with care and perceived impact of race on components of care, including respect, communication, and quality of care. A 6‐point Likert scale was used, and chi‐square and Wilcoxon rank sum tests were used to analyze responses. Results A total of 590 (14%) discharged patients consented, and 462 patients completed the entire survey; the mean age was 43 years (SD 17.3); 67% were women, and 60.0% were Black. Black patients reported a higher overall rating of ED care (median 5 [3, 5]; P = 0.013). Proportionately, when compared with White patients, more Black patients reported that race negatively impacted the rating of care (10.8% vs 1.4%; P = 0.002). More than a quarter of Black patients (27.4%) reported race highly impacting being treated with respect (P = 0.024), and 22.4% reported a high impact on quality of service (P = 0.003) when compared with White patients. Conclusion Health systems lack methods that specifically identify patient experiences of racism. We demonstrate the feasibility of using text messaging to collect patient‐reported experiences of racism. For a significant number of Black patients, race negatively impacted their care, including communication, quality, and respect.https://doi.org/10.1002/emp2.12870digital healthequitylearning health systemsquality improvmentracisim |
| spellingShingle | Anish K. Agarwal Charlotte Sagan Rachel Gonzales Sally Nijim Raina M. Merchant David A. Asch Eugenia C. South Assessing experiences of racism among Black and White patients in the emergency department Journal of the American College of Emergency Physicians Open digital health equity learning health systems quality improvment racisim |
| title | Assessing experiences of racism among Black and White patients in the emergency department |
| title_full | Assessing experiences of racism among Black and White patients in the emergency department |
| title_fullStr | Assessing experiences of racism among Black and White patients in the emergency department |
| title_full_unstemmed | Assessing experiences of racism among Black and White patients in the emergency department |
| title_short | Assessing experiences of racism among Black and White patients in the emergency department |
| title_sort | assessing experiences of racism among black and white patients in the emergency department |
| topic | digital health equity learning health systems quality improvment racisim |
| url | https://doi.org/10.1002/emp2.12870 |
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