National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Adverse Drug Events (ADE) (1)
- Antibiotics (1)
- Anxiety (1)
- Asthma (1)
- Blood Pressure (3)
- Brain Injury (1)
- Cardiovascular Conditions (1)
- Care Management (1)
- Children/Adolescents (5)
- Communication (4)
- Community-Acquired Infections (1)
- Comparative Effectiveness (1)
- Decision Making (3)
- Depression (1)
- Diagnostic Safety and Quality (2)
- Disparities (1)
- Elderly (5)
- Electronic Health Records (EHRs) (5)
- (-) Emergency Department (49)
- Emergency Medical Services (EMS) (15)
- Evidence-Based Practice (1)
- Falls (1)
- Guidelines (1)
- Healthcare Cost and Utilization Project (HCUP) (6)
- Healthcare Delivery (1)
- Healthcare Utilization (3)
- Health Information Exchange (HIE) (3)
- Health Information Technology (HIT) (5)
- Health Insurance (1)
- Health Literacy (1)
- Health Services Research (HSR) (3)
- Heart Disease and Health (2)
- Hospital Discharge (4)
- Hospitalization (3)
- Hospital Readmissions (5)
- Human Immunodeficiency Virus (HIV) (1)
- Imaging (3)
- Infectious Diseases (1)
- Inpatient Care (1)
- Low-Income (1)
- Maternal Care (1)
- Medicaid (3)
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- Medication (3)
- Medication: Safety (1)
- Methicillin-Resistant Staphylococcus aureus (MRSA) (1)
- Mortality (1)
- Nursing (2)
- Nursing Homes (1)
- Opioids (2)
- Pain (3)
- Patient-Centered Healthcare (1)
- Patient-Centered Outcomes Research (1)
- Patient Safety (5)
- Policy (1)
- Practice Patterns (2)
- Prevention (2)
- Primary Care (2)
- Provider: Health Personnel (3)
- Provider: Physician (1)
- Quality Improvement (1)
- Quality Indicators (QIs) (1)
- Quality Measures (2)
- Quality of Care (4)
- Racial and Ethnic Minorities (2)
- Risk (2)
- Rural Health (1)
- Screening (2)
- Sex Factors (1)
- Sickle Cell Disease (1)
- Social Determinants of Health (4)
- Stress (1)
- Stroke (1)
- Substance Abuse (1)
- Surgery (2)
- Teams (1)
- TeamSTEPPS (1)
- Telehealth (1)
- Urban Health (1)
- Women (1)
- Workflow (1)
- Young Adults (1)
AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 25 of 49 Research Studies DisplayedBenda N, Hettinger A, Bisantz A
Communication in the electronic age: an analysis of face-to-fact physician-nurse communication in the emergency department.
This study described the patterns and content of nurse to physician verbal conversations in three emergency departments (EDs) with electronic health records. It found that physician participants experienced significantly more communication events than nurse participants, while nurses initiated significantly more communication events than physicians. Most of the communication events occurred at the physician workstation followed by patient treatment areas.
AHRQ-funded; HS022542.
Citation: Benda N, Hettinger A, Bisantz A .
Communication in the electronic age: an analysis of face-to-fact physician-nurse communication in the emergency department.
Journal of Healthcare Informatics Research 2017 Dec;1(2):218-30.
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Keywords: Communication, Electronic Health Records (EHRs), Provider: Health Personnel, Emergency Department, Nursing
Raven MC, Guzman D, Chen AH
Out-of-network emergency department use among managed Medicaid beneficiaries.
The researchers examined factors associated with out-of-network ED use among Medicaid beneficiaries. They concluded that there are a number of factors related to out-of-network ED use, including the proximity and density of out-of-network EDs, race and ethnicity, a prior history of out-of-network ED use, and individuals' connection to primary care.
AHRQ-funded; HS021700.
Citation: Raven MC, Guzman D, Chen AH .
Out-of-network emergency department use among managed Medicaid beneficiaries.
Health Serv Res 2017 Dec;52(6):2156-74. doi: 10.1111/1475-6773.12604.
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Keywords: Emergency Department, Emergency Medical Services (EMS), Medicaid, Primary Care, Social Determinants of Health
Daniels B, Schoenfeld E, Taylor A
Predictors of hospital admission and urological intervention in adult emergency department patients with computerized tomography confirmed ureteral stones.
In this paper, the authors describe predictors of hospital admission or urological intervention. The investigators concluded that intervention was common among admitted patients but occurred in a minority of those discharged. Predictors of intervention varied by disposition. Models incorporating computerized tomography findings were similar to those that did not incorporate such findings. The authors suggest that their data support ultrasound first or delayed computerized tomography diagnostic pathways for patients deemed clinically suitable for discharge home.
AHRQ-funded; HS018322; HS022236.
Citation: Daniels B, Schoenfeld E, Taylor A .
Predictors of hospital admission and urological intervention in adult emergency department patients with computerized tomography confirmed ureteral stones.
J Urol 2017 Dec;198(6):1359-66. doi: 10.1016/j.juro.2017.06.077..
Keywords: Emergency Department, Imaging
Lines LM, Rosen AB, Ash AS
Enhancing administrative data to predict emergency department utilization: the role of neighborhood sociodemographics.
Much of emergency department (ED) use is avoidable, and high-quality primary care can reduce it, but performance measures related to ED use may be inadequately risk-adjusted. To explore associations between ED use and neighborhood poverty, a secondary analysis of Massachusetts managed care network data, 2009-2011, was conducted.
AHRQ-funded; HS022194.
Citation: Lines LM, Rosen AB, Ash AS .
Enhancing administrative data to predict emergency department utilization: the role of neighborhood sociodemographics.
J Health Care Poor Underserved 2017;28(4):1487-508. doi: 10.1353/hpu.2017.0129..
Keywords: Emergency Department, Low-Income, Social Determinants of Health, Healthcare Utilization
Aalsma MC, Anderson VR, Schwartz K
Preventive care use among justice-involved and non-justice-involved youth.
The objective of this study was to determine how rates of well-child (WC) and emergency department visits, as well as public insurance enrollment continuity, differed between youth involved in the justice system (JIY) and youth who have never been in the system (NJIY). It found that JIY had lower use rates of WC visits and higher use rates of emergency services in comparison with NJIY. JIY had more and longer gaps in Medicaid coverage compared with NJIY.
AHRQ-funded; HS023318.
Citation: Aalsma MC, Anderson VR, Schwartz K .
Preventive care use among justice-involved and non-justice-involved youth.
Pediatrics 2017 Nov;140(5):pii: e20171107. doi: 10.1542/peds.2017-1107.
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Keywords: Children/Adolescents, Emergency Department, Healthcare Utilization, Medicaid
Probst MA, Kanzaria HK, Schoenfeld EM
Shared decisionmaking in the emergency department: a guiding framework for clinicians.
The authors developed a simple framework to illustrate how shared decisionmaking should be approached in clinical practice. They believe it should be the preferred or default approach to decisionmaking, except in clinical situations in which 3 factors interfere. These 3 factors are lack of clinical uncertainty or equipoise, patient decisionmaking ability, and time, all of which can render shared decisionmaking infeasible. The authors next discuss how to address each factor.
AHRQ-funded; HS021271; HS024311.
Citation: Probst MA, Kanzaria HK, Schoenfeld EM .
Shared decisionmaking in the emergency department: a guiding framework for clinicians.
Ann Emerg Med 2017 Nov;70(5):688-95. doi: 10.1016/j.annemergmed.2017.03.063.
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Keywords: Decision Making, Emergency Department, Emergency Medical Services (EMS), Evidence-Based Practice, Guidelines
Boyce RD, Jao J, Miller T
Automated screening of emergency department notes for drug-associated bleeding adverse events occurring in older adults.
The purpose of this study was to conduct research to show the value of text mining for automatically identifying suspected bleeding adverse drug events (ADEs) in the emergency department (ED). The investigators found that both models they examined, accurately identify bleeding ADEs using the presence or absence of certain clinical concepts in ED admission notes for older adult patients.
AHRQ-funded; HS024208.
Citation: Boyce RD, Jao J, Miller T .
Automated screening of emergency department notes for drug-associated bleeding adverse events occurring in older adults.
Appl Clin Inform 2017 Oct;8(4):1022-30. doi: 10.4338/aci-2017-02-ra-0036..
Keywords: Adverse Drug Events (ADE), Elderly, Emergency Department, Medication, Medication: Safety
Zachrison KS, Hayden EM, Schwamm LH
Characterizing New England emergency departments by telemedicine use.
The primary objective of this study was to describe the prevalence of telemedicine use in New England EDs and the clinical applications of use. It concluded that telemedicine is commonly used in New England EDs. In 2014, use was more common among rural EDs and EDs with limited neurology consultant availability. In contrast, telemedicine use was less common among very low-volume EDs.
AHRQ-funded; HS024561.
Citation: Zachrison KS, Hayden EM, Schwamm LH .
Characterizing New England emergency departments by telemedicine use.
West J Emerg Med 2017 Oct;18(6):1055-60. doi: 10.5811/westjem.2017.8.34880.
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Keywords: Emergency Department, Emergency Medical Services (EMS), Healthcare Delivery, Health Services Research (HSR), Telehealth
Davies S, Schultz E, Raven M
AHRQ Author: Stocks C
Development and validation of the Agency for Healthcare Research and Quality Measures of Potentially Preventable Emergency Department (ED) Visits: the ED Prevention Quality Indicators for general health conditions.
The researchers sought to develop and validate rates of potentially preventable emergency department (ED) visits as indicators of community health. ED Prevention Quality Indicators (PQI) rates varied widely across U.S. communities. Indicator rates were significantly associated with county-level poverty, median income, Medicaid insurance, and levels of uninsurance. A few indicators were significantly associated with PCP density, with higher rates in areas with greater density.
AHRQ-authored; AHRQ-funded; 2902012000031.
Citation: Davies S, Schultz E, Raven M .
Development and validation of the Agency for Healthcare Research and Quality Measures of Potentially Preventable Emergency Department (ED) Visits: the ED Prevention Quality Indicators for general health conditions.
Health Serv Res 2017 Oct;52(5):1667-84. doi: 10.1111/1475-6773.12687.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Emergency Department, Quality Indicators (QIs), Patient Safety, Prevention
Tedesco D, Asch SM, Curtin C
Opioid abuse and poisoning: trends in inpatient and emergency department discharges.
This study analyzed national trends in inpatient and emergency department (ED) discharges for opioid abuse, dependence, and poisoning using Healthcare Cost and Utilization Project data.
AHRQ-funded; HS024096.
Citation: Tedesco D, Asch SM, Curtin C .
Opioid abuse and poisoning: trends in inpatient and emergency department discharges.
Health Aff 2017 Oct;36(10):1748-53. doi: 10.1377/hlthaff.2017.0260..
Keywords: Emergency Department, Healthcare Cost and Utilization Project (HCUP), Hospital Discharge, Opioids, Substance Abuse
Goyal MK, Johnson TJ, Chamberlain JM
Racial and ethnic differences in antibiotic use for viral illness in emergency departments.
The researchers sought to investigate whether patient race and ethnicity was associated with differences in antibiotic prescribing for viral acute respiratory tract infections (ARTIs) in the pediatric emergency department (PED). They found that compared with non-Hispanic (NH) white children, NH black and Hispanic children were less likely to receive antibiotics for viral ARTIs in the PED.
AHRQ-funded; HS020270.
Citation: Goyal MK, Johnson TJ, Chamberlain JM .
Racial and ethnic differences in antibiotic use for viral illness in emergency departments.
Pediatrics 2017 Oct;140(4). doi: 10.1542/peds.2017-0203.
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Keywords: Racial and Ethnic Minorities, Emergency Department, Children/Adolescents, Disparities, Practice Patterns
Hernandez-Boussard T, Graham LA, Desai K
The fifth vital sign: postoperative pain predicts 30-day readmissions and subsequent emergency department visits.
The researchers hypothesized that inpatient postoperative pain trajectories are associated with 30-day inpatient readmission and emergency department (ED) visits. After analyzing National Veterans Affairs Surgical Quality Improvement data on inpatient general, vascular, and orthopedic surgery from 2008 to 2014, they concluded that postoperative pain trajectories identify populations at risk for 30-day readmissions and ED visits, and do not seem to be mediated by postdischarge complications.
AHRQ-funded; HS024096.
Citation: Hernandez-Boussard T, Graham LA, Desai K .
The fifth vital sign: postoperative pain predicts 30-day readmissions and subsequent emergency department visits.
Ann Surg 2017 Sep;266(3):516-24. doi: 10.1097/sla.0000000000002372.
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Keywords: Emergency Department, Hospital Readmissions, Pain
Patterson BW, Smith MA, Repplinger MD
Using chief complaint in addition to diagnosis codes to identify falls in the emergency department.
The researchers compared incidence of falls in an emergency department (ED) cohort using a traditional International Classification of Diseases, Ninth Revision (ICD-9) code-based scheme and an expanded definition that included chief complaint information. They concluded that identifying individuals in the ED who have fallen based on diagnosis codes underestimates the true burden of falls.
AHRQ-funded; HS024558.
Citation: Patterson BW, Smith MA, Repplinger MD .
Using chief complaint in addition to diagnosis codes to identify falls in the emergency department.
J Am Geriatr Soc 2017 Sep;65(9):E135-E40. doi: 10.1111/jgs.14982.
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Keywords: Falls, Emergency Medical Services (EMS), Emergency Department
Tiase VL, Crouch B, Bennett H
Descriptive analysis of communication patterns between a local poison control center and community emergency departments.
This study leverages a commercial call recording system to gain insight into the intensity and volume of communication between a poison control center and two rural emergency departments.
AHRQ-funded; HS021472.
Citation: Tiase VL, Crouch B, Bennett H .
Descriptive analysis of communication patterns between a local poison control center and community emergency departments.
2017 IEEE International Conference on Healthcare Informatics (ICHI) 2017 Aug:574. doi: 10.1109/ICHI.2017.89.
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Keywords: Communication, Emergency Department, Emergency Medical Services (EMS), Rural Health
Vouri SM, Olsen MA, Theodoro D
Treated-and-released urinary catheterization in the emergency department by sex.
The prevalence of conditions associated with urinary catheterization (UC) visits in men and women were identified. The rate of UC in treated-and-released ED visits was higher in men than women, and UC rate increased with age. The heterogeneity of conditions coded in UC visits in women compared with men may suggest more potentially avoidable UC in women in the treated-and-released ED population.
AHRQ-funded; HS019455.
Citation: Vouri SM, Olsen MA, Theodoro D .
Treated-and-released urinary catheterization in the emergency department by sex.
Am J Infect Control 2017 Aug;45(8):905-10. doi: 10.1016/j.ajic.2017.02.025.
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Keywords: Emergency Department, Healthcare Cost and Utilization Project (HCUP), Sex Factors
Finnegan MA, Shaffer R, Remington A
Emergency department visits following elective total hip and knee replacement surgery: identifying gaps in continuity of care.
The researchers sought to characterize 30-day ED visits following a major joint replacement surgical procedure. They concluded that ED visits following an elective major joint replacement surgical procedure were numerous and most commonly for pain-related diagnoses. Medicaid patients had almost double the risk of an ED or pain-related ED visit following a surgical procedure.
AHRQ-funded; HS024096.
Citation: Finnegan MA, Shaffer R, Remington A .
Emergency department visits following elective total hip and knee replacement surgery: identifying gaps in continuity of care.
J Bone Joint Surg Am 2017 Jun 21;99(12):1005-12. doi: 10.2106/jbjs.16.00692.
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Keywords: Care Management, Emergency Department, Surgery
Dharmarajan K, Qin L, Bierlein M
Outcomes after observation stays among older adult Medicare beneficiaries in the USA: retrospective cohort study.
This study characterized rates and trends over time of emergency department treatment-and-discharge stays, repeat observation stays, inpatient stays, any hospital revisit, and death within 30 days of discharge from observation stays. Hospital revisits are common after discharge from observation stays, frequently result in inpatient hospitalizations, and have increased over time among Medicare beneficiaries.
AHRQ-funded; HS023000.
Citation: Dharmarajan K, Qin L, Bierlein M .
Outcomes after observation stays among older adult Medicare beneficiaries in the USA: retrospective cohort study.
BMJ 2017 Jun 20;357:j2616. doi: 10.1136/bmj.j2616.
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Keywords: Elderly, Emergency Department, Hospital Discharge, Hospital Readmissions, Medicare
Melnick ER, Hess EP, Guo G
Patient-centered decision support: formative usability evaluation of integrated clinical decision support with a patient decision aid for minor head injury in the emergency department.
The study’s objective was to formatively evaluate an electronic tool that not only helps clinicians at the bedside to determine the need for CT use based on the Canadian CT Head Rule but also promotes evidence-based conversations between patients and clinicians regarding patient-specific risk and patients' specific concerns. It concluded that the Concussion or Brain Bleed app is a useful and usable final product integrating clinical decision support with a patient decision aid.
AHRQ-funded; HS021271.
Citation: Melnick ER, Hess EP, Guo G .
Patient-centered decision support: formative usability evaluation of integrated clinical decision support with a patient decision aid for minor head injury in the emergency department.
J Med Internet Res 2017 May 19;19(5):e174. doi: 10.2196/jmir.7846.
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Keywords: Brain Injury, Decision Making, Emergency Department, Health Information Technology (HIT), Patient-Centered Healthcare
Goldberg EM, Wilson T, Saucier C
Achieving the BpTRUth: emergency department hypertension screening and the Centers for Medicare & Medicaid Services quality measure.
The aims of this study were to (1) assess the reliability of ED triage blood pressure (BP) as a metric to establish when the CMS threshold (>/=120/80 mm Hg), and other clinically relevant BP thresholds (>/=140/90 and >/=160/100 mm Hg) have been met; and (2) determine whether correct identification varies by gender, race, or triage acuity. At the three suggested BP thresholds, 66.1 percent, 74.0 percent, and 88.8 percent of patients were confirmed to meet the CMS threshold, respectively. There were no differences by gender, race, or triage acuity.
AHRQ-funded; HS000011.
Citation: Goldberg EM, Wilson T, Saucier C .
Achieving the BpTRUth: emergency department hypertension screening and the Centers for Medicare & Medicaid Services quality measure.
J Am Soc Hypertens 2017 May;11(5):290-94. doi: 10.1016/j.jash.2017.03.003.
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Keywords: Blood Pressure, Emergency Department, Quality Measures, Screening, Diagnostic Safety and Quality, Quality of Care
Benda NC, Fairbanks RJ, Fairbanks RJ
Are you paying attention? Related guidance on how concepts of attention may inform effective time sharing of tasks in emergency medicine.
The authors respond to an earlier article providing a thoughtful introduction to the importance of teaching effective task switching in emergency medicine. Their letter introduces the concept of attention, provides examples of tasks that can be most safely and effectively time shared, and notes that these principles must be considered in designing tools for the time sharing and rapid switching of tasks necessary in the ED environment.
AHRQ-funded; HS022542.
Citation: Benda NC, Fairbanks RJ, Fairbanks RJ .
Are you paying attention? Related guidance on how concepts of attention may inform effective time sharing of tasks in emergency medicine.
Ann Emerg Med 2017 May;69(5):669-70. doi: 10.1016/j.annemergmed.2017.01.027.
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Keywords: Workflow, Emergency Medical Services (EMS), Emergency Department, Patient Safety
Brousseau EC, Danilack V, Cai F
Emergency department visits for postpartum hypertension.
The purpose of this study was to describe the characteristics of women diagnosed with postpartum hypertension in an emergency department (ED) to better inform postpartum care. The investigators compared women with an ED diagnosis of hypertension to women with all other ED diagnoses and concluded that postpartum surveillance may not prevent readmission for hypertension.
AHRQ-funded; HS025013.
Citation: Brousseau EC, Danilack V, Cai F .
Emergency department visits for postpartum hypertension.
Hypertens Pregnancy 2017 May;36(2):212-16. doi: 10.1080/10641955.2017.1299171..
Keywords: Emergency Department, Blood Pressure, Maternal Care, Women
Everson J, Kocher KE, Adler-Milstein J
Health information exchange associated with improved emergency department care through faster accessing of patient information from outside organizations.
This study assessed whether electronic health information exchange (HIE) is associated with improved emergency department (ED) care processes and utilization through more timely clinician viewing of information from outside organizations. It concluded that the relationship between HIE and improved care processes and reduced utilization in the ED is mediated by faster accessing of information from outside organizations.
AHRQ-funded; HS024160.
Citation: Everson J, Kocher KE, Adler-Milstein J .
Health information exchange associated with improved emergency department care through faster accessing of patient information from outside organizations.
J Am Med Inform Assoc 2017 Apr 1;24(e1):e103-e10. doi: 10.1093/jamia/ocw116.
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Keywords: Electronic Health Records (EHRs), Emergency Department, Emergency Medical Services (EMS), Quality of Care, Health Information Exchange (HIE)
Haber SG, Wensky SG, McCall NT
Reducing inpatient hospital and emergency room utilization among nursing home residents.
This study examined the association among nursing home residents between strength of relationship with a primary care provider (PCP) and inpatient hospital and emergency room (ER) utilization. Both measures of strength of patient-provider relationships were associated with fewer inpatient admissions and ER visits, except regularity of PCP visits and ambulatory care sensitive conditions (ACSC) ER visits.
AHRQ-funded; HS000029.
Citation: Haber SG, Wensky SG, McCall NT .
Reducing inpatient hospital and emergency room utilization among nursing home residents.
J Aging Health 2017 Apr;29(3):510-30. doi: 10.1177/0898264316641074.
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Keywords: Elderly, Emergency Department, Hospitalization, Nursing Homes, Primary Care
Clark LN, Benda NC, Hegde S
Usability evaluation of an emergency department information system prototype designed using cognitive systems engineering techniques.
This article presents an evaluation of novel display concepts for an emergency department information system (EDIS) designed using cognitive systems engineering methods. It concluded that nurse and provider roles had significantly different perceptions of the usability and usefulness of certain EDIS components, suggesting that they have different information needs while working.
AHRQ-funded; HS022542; HS020433.
Citation: Clark LN, Benda NC, Hegde S .
Usability evaluation of an emergency department information system prototype designed using cognitive systems engineering techniques.
Appl Ergon 2017 Apr;60:356-65. doi: 10.1016/j.apergo.2016.12.018.
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Keywords: Health Information Technology (HIT), Emergency Department, Emergency Medical Services (EMS), Health Information Technology (HIT)
Johnson TJ, Winger DG, Hickey RW
Comparison of physician implicit racial bias toward adults versus children.
This study compared implicit racial bias toward adults versus children among resident physicians working in a pediatric emergency department. It found that resident physicians have implicit racial bias against black children, similar to levels of bias against black adults. Bias in the study did not vary by resident demographic characteristics, including specialty, suggesting that pediatric residents are as susceptible as other physicians to implicit bias.
AHRQ-funded; HS017587.
Citation: Johnson TJ, Winger DG, Hickey RW .
Comparison of physician implicit racial bias toward adults versus children.
Acad Pediatr 2017 Mar;17(2):120-26. doi: 10.1016/j.acap.2016.08.010.
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Keywords: Children/Adolescents, Emergency Department, Provider: Health Personnel, Children/Adolescents, Racial and Ethnic Minorities