The Principal Investigator

If you’re an African American seeking emergency care in the United States, you can count on spending an extra hour waiting for a hospital bed than all other groups, according to the results of a national survey.

The findings, published in the February online issue of the journal Academic Emergency Medicine, are the latest to shine a light on the inequities in U.S. hospitals and point to a possible root of health disparities.

“What’s most concerning is the longer people stay in the [Emergency Department], the more like they are to die,” lead author Jesse Pines, of the University of Pennsylvania, said in a news release.

The researchers sifted through roughly 14,500 hospital admissions from the emergency departments at 408 U.S. hospitals between 2003 and 2005, to analyze the time patients spent in the emergency department before being transferred to a intensive care unit (ICU) bed or a non-ICU bed. The analyzed data set was from the National Hospital Ambulatory Medical Care Survey, an annual assessment of the nation’s Emergency Departments. The data set represented estimates apply to approximately 339.4 million Emergency Department visits, according to the authors of the study.

The results revealed that wait times for black patients clock in at nearly six and one-quarter hours while non-black patients were in beds at just under 5 hours. Among the nation’s sickest patients waiting for ICU beds, fifty-seven percent of blacks waited more than 6 hours for an ICU bed in compared to 37 percent of non-blacks.

“Some of the greatest medical advancements of the last decade can be totally erased by spending a couple hours longer than necessary in the [Emergency Department],” study coauthor Judd Hollander, also of the University of Pennsylvania, said in a news release.

“Even prior to the economic downturn, some institutions had actually begun prioritizing hospital beds for insured patients having lucrative elective procedures. These measures will only worsen disparities for minorities,” he added.

Related links:

White House health forum must eliminate health disparities says USVI Delegate (Caribbean Net News, 3.6.09)

Ex-Foes of Health-Care Reform Emerge as Supporters (The Washington Post, 3.6.09)

Report finds racial disparities in access to hospital care (The Seattle Medium, 3.4.09)

During a period when former inmates are most vulnerable to engage in old substance abuse or risky sexual behaviors, a new study finds that an alarmingly high numbers of HIV-positive inmates fresh out of jail are not taking the drugs they need.

The study, published today (2.25.09) in the Journal of the American Medical Association, found that after receiving antiretroviral therapy (ART) to treat HIV while in prison, 70 percent of HIV-positive inmates fail to continue treatment 60 days after their release. This disruption in treatment increases the risk the patients will become more infectious and resistant to future drug therapy, further exacerbating the threat to the surrounding community.

“Several studies suggest that many released inmates who discontinue antiretroviral therapy also resume high-risk behaviors such as injection drug use or unsafe sex, and this combination may result not only in poor clinical outcomes for these individuals but also in the creation of drug-resistant HIV reservoirs in the general community,” University of Texas Medical Branch (UTMB) at Galveston epidemiologist and study co-author Jacques Baillargeon said in a news release. More than 1.1 million people living in the United States are infected with HIV, according a 2006 assessment by The Centers for Disease Control and Prevention (CDC), the most recent data available.

The team of researchers tracked more than 2,100 HIV-positive inmates released from the Texas Department of Criminal Justice, the nation’s largest state prison system, between January 2004 and December 2007.

Though HIV-positive inmates followed their ART regimen while in prison, only 5 percent filled a prescription within 10 days after release from prison, so as to not disrupt their treatment. Eighteen percent of the former inmates filled their ART prescription within 30 days; by 60 days, only 30 percent of the inmates had filled prescriptions.

“These remarkably high rates of lengthy HIV treatment interruptions are troublesome from a public health perspective,” Baillargeon said.

Access to ART is only one of many factors former inmates face when they are released from prison. Finding a job and housing while fighting mental and substance abuse issues with little or no private or public insurance also complicates rehabilitation into the surrounding community.

“A solution to this problem will require carefully coordinated efforts between the criminal justice system, public health agencies, and community healthcare systems,” study co-author David Parr, of the UTMB Correctional Managed Care, said in a news release.