title: A research agenda to assure equity during periods of emergency department crowding.
abstract: The effect of emergency department (ED) crowding on equitable care is the least studied of the domains of quality as defined by the Institute of Medicine (IOM). Inequities in access and treatment throughout the health care system are well documented in all fields of medicine. While there is little evidence demonstrating that inequity is worsened by crowding, theory and evidence from social science disciplines, as well as known barriers to care for vulnerable populations, would suggest that crowding will worsen inequities. To design successful interventions, however, it is important to first understand how crowding can result in disparities and base interventions on these mechanisms. A research agenda is proposed to understand mechanisms that may threaten equity during periods of crowding and design and test potential interventions that may ensure the equitable aspect of quality of care.
authors.affiliation: Department of Emergency Medicine, Mount Sinai School of Medicine, New York, NY, USA. ula.hwang@mountsinai.org
authors.forename: Ula
authors.initials: U
authors.lastname: Hwang
authors.forename: Ellen J
authors.initials: EJ
authors.lastname: Weber
authors.forename: Lynne D
authors.initials: LD
authors.lastname: Richardson
authors.forename: Vicki
authors.initials: V
authors.lastname: Sweet
authors.forename: Knox
authors.initials: K
authors.lastname: Todd
authors.forename: Gallane
authors.initials: G
authors.lastname: Abraham
authors.forename: Felix
authors.initials: F
authors.lastname: Ankel
mesh_terms: D003441:Crowding; D004635:Emergency Medicine / Q000458:organization & administration*; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006302:Health Services Research; D054625:Healthcare Disparities / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D010348:Patient Care Team / Q000458:organization & administration; D061214:Patient Safety; D010818:Practice Patterns, Physicians'; D011785:Quality Assurance, Health Care; D014481:United States