Socioeconomic status and time to provider for patients with sickle cell disease
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Abstract
Disparities in healthcare access and quality for patients with sickle cell disease (SCD) continue to pose significant challenges. This study aims to examine the relationship between socioeconomic factors and the time patients with SCD wait to see a provider in the emergency department (ED). Using a retrospective, comparative analysis of data from the National Hospital Ambulatory Medical Care Survey (NHAMCS) ED sample between 2008-2018, this study includes ED visits of patients with SCD aged 18 and older who present with a pain crisis. The outcome variable is time to provider (TTP), defined as the length of time between patient arrival to the ED and the first interaction with a medical provider. Socioeconomic factors of interest include sex, employment, and education level. Covariates such as age, race, acuity, and time of presentation are considered. Statistical analyses include t-tests, one-way ANOVA, and multiple linear regression, along with evaluation of interaction effects. The study's timeline is three to four months, and resources include a computer with statistical software and personnel assistance. While limitations exist, including the reliance on NHAMCS data and the subjective nature of some measurements, the study aims to provide insights into the impact of socioeconomic factors on wait times in the ED for patients with SCD. The results have clinical and public health significance, highlighting implicit biases, care delays, and potential detrimental effects on patient well-being. The findings can inform interventions such as provider education, pain management protocols, individualized pain plans, support groups, and improved access to primary care and social services. Overall, this study contributes to the understanding of disparities in care for patients with SCD and aims to improve the quality of healthcare for this population.