Emergency department care experiences among members of equity-deserving groups: quantitative results from a cross-sectional mixed methods study

BMC Emergency Medicine

Research

Amanda Collier¹  Jodie Pritchard¹  Stuart L. Douglas²  David Messenger²  Susan A. Bartels³  Melanie Walker³  Meredith MacKenzie⁴  Eva Purkey⁵ 

[1] Department of Emergency Medicine, Queen’s University, Kingston, ON, Canada;Department of Emergency Medicine, Queen’s University, Kingston, ON, Canada;Department of Critical Care Medicine, Queen’s University, Kingston, ON, Canada;Department of Emergency Medicine, Queen’s University, Kingston, ON, Canada;Department of Public Health Sciences, Queen’s University, Kingston, ON, Canada;Department of Family Medicine, Queen’s University, Kingston, ON, Canada;Street Health Centre, part of Kingston Community Health Centres, Kingston, ON, Canada;Department of Public Health Sciences, Queen’s University, Kingston, ON, Canada;Department of Family Medicine, Queen’s University, Kingston, ON, Canada;

关键词: Addiction medicine;    Disability;    Emergency medicine;    Equity-deserving groups;    Health policy;    Indigenous health;    Mental health;    Substance use disorder;    Vulnerably housed;    Visible minority;   

DOI  :  10.1186/s12873-023-00792-z

 received in 2022-11-15, accepted in 2023-02-15,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundEmergency departments (EDs) serve an integral role in healthcare, particularly for vulnerable populations. However, marginalized groups often report negative ED experiences, including stigmatizing attitudes and behaviours. We engaged with historically marginalized patients to better understand their ED care experiences.MethodParticipants were invited to complete an anonymous mixed-methods survey about a previous ED experience. We analysed quantitative data including controls and equity-deserving groups (EDGs) - those who self-identified as: (a) Indigenous; (b) having a disability; (c) experiencing mental health issues; (d) a person who uses substances; (e) a sexual and gender minority; (f) a visible minority; (g) experiencing violence; and/or (h) facing homelessness - to identify differences in their perspectives. Differences between EDGs and controls were calculated with chi squared tests, geometric means with confidence ellipses, and the Kruskal-Wallis H test.ResultsWe collected a total of 2114 surveys from 1973 unique participants, 949 controls and 994 who identified as equity-deserving. Members of EDGs were more likely to attribute negative feelings to their ED experience (p < 0.001), to indicate that their identity impacted the care received (p < 0.001), and that they felt disrespected and/or judged while in the ED (p < 0.001). Members of EDGs were also more likely to indicate that they had little control over healthcare decisions (p < 0.001) and that it was more important to be treated with kindness/respect than to receive the best possible care (p < 0.001).ConclusionMembers of EDGs were more likely to report negative ED care experiences. Equity-deserving individuals felt judged and disrespected by ED staff and felt disempowered to make decisions about their care. Next steps will include contextualizing findings using participants’ qualitative data and identifying how to improve ED care experiences among EDGs to make it more inclusive and better able to meet their healthcare needs.

【 授权许可】

CC BY   
© The Author(s) 2023

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