Waiting Time at the Emergency Department from a Gender Equality Perspective

Abstract

Master thesis, Programme in Medicine. TITLE: Waiting Time at the Emergency Department from a Gender Equality Perspective. Introduction Increasing patient load and longer waiting times at the emergency departments are well-known phenomena. A central function is the so-called triage system for prioritization of the patients. Only a few studies address the question if there is a gender bias in triaging and waiting time.

Aim To quantify gender effects in a large mixed population of patients seeking health care at a large emergency department and, on the basis of the magnitude of the gender difference in subpopulations draw conclusions regarding possible causes of observed gender effects.

Methods The patient material consisted of all cases seeking medical care at the emergency ward of the Östra Hospital during 2009-2012. They were divided into subgroups on the basis of gender, chief complaint, age and socioeconomic status. A standardized formula (RETTSTM) was used in the triaging process and the patients were prioritized with one of five colors. Three time registrations were recorded; time to triage (TTT), time to doctor (TTD) and total lead time (TLT).

Results 135 417 patients were included in the study with a mean age of 54,2 years. They came from all parts of Gothenburg. Men were more often triaged red/orange and women more often green/yellow. There was no gender difference in TTT. The mean TTD and TLT were significantly longer for females than for males in the entire material, with an approximate magnitude of 15 minutes. The gender signal was seen independently of the chief complaint, in both medical and surgical cases. The signal disappeared among old seriously ill patients and among patients from residence areas with high socioeconomic status.

Conclusion We observed differences in waiting times and triage priority levels that are hard to explain on the basis of presenting symptoms. The magnitude of the gender dependent signal was affected by age and socioeconomic status.

Key words Waiting Time at the Emergency Department from a Gender Equality Perspective,, waiting times, gender, age, socioeconomy