Disparities in Care: The Role of Race on the Utilization of Physical Restraints in the Emergency Setting.

Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine
Kristina SchnitzerSuzanne Bird

Abstract

Race-based bias in health care occurs at organizational, structural, and clinical levels and impacts emergency medical care. Limited literature exists on the role of race on patient restraint in the emergency setting. This study sought to examine the role of race in physical restraint in an emergency department (ED) at a major academic medical center. Retrospective chart analysis was performed, querying all adult ED visits over a 2-year period (2016-2018) at Massachusetts General Hospital. The associations between race and restraint and selected covariates (sex, insurance, age, diagnosis, homelessness, violence) were analyzed. Of the 195,092 unique ED visits by 120,469 individuals over the selected period, 2,658 (1.4%) involved application of a physical restraint by health care providers. There was a significant effect of race on restraint (p < 0.0001). The risk ratio (RR) for Asian patients compared to white patients was 0.71 (95% confidence interval [CI] = 0.55 to 0.92, p = 0.009). The RR for Black patients compared to white patients was 1.22 (95% CI = 1.05 to 1.40, p = 0.007). Visits with patients having characteristics of male sex, public or no insurance, younger age, diagnoses pertaining to substance use, diagnoses pertain...Continue Reading

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Citations

Sep 12, 2020·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·R Andrew TaylorAmbrose H Wong
Jul 22, 2020·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Ted J CorbinJohn A Rich
Mar 3, 2021·Journal of Emergency Nursing : JEN : Official Publication of the Emergency Department Nurses Association·Tabitha F LegambiMary Zaleski
Mar 28, 2021·The Journal of Pediatrics·Ashley A FosterJoel D Hudgins
Apr 17, 2021·Journal of Emergency Nursing : JEN : Official Publication of the Emergency Department Nurses Association·Anne Manton
Apr 15, 2021·Journal of Psychiatric and Mental Health Nursing·Lee HollinsBrendon Stubbs
Jun 3, 2021·Psychiatric Services : a Journal of the American Psychiatric Association·Samuel DotsonDerri Shtasel
May 13, 2021·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Rowen O JinRohini J Haar
Aug 8, 2021·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Makini Chisolm-StrakerJeffrey A Kline
Sep 18, 2021·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Jossie A Carreras TartakWendy L Macias-Konstantopoulos

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