Hello, my name is Zach Monahan. I'm a third-year medical student from Oklahoma State University. I'm going to be presenting this paper, Emergency Room Wait Times for Psychiatric Conditions from 2019 to 2021. I worked on this paper with student doctors, Allison Mack and Anna Place, as well as Dr. Pierce, who is a psychiatrist and hospitalist, who helped clinically review the paper, and Dr. Micah Hartwell, who helped with the research and statistics of the paper. What sparked this research question was, in the middle of this 2019 to 2021 timeframe, was the COVID-19 pandemic, which saw a large increase in people coming to the ER with severe COVID exacerbations or COVID-related illnesses. However, once all the dust settled, you'll see there's data supporting that in 2019 to 2021, there was actually a 39% decrease in all-cause ED visits. However, over the same timeframe, there was a 93% increase in people seeking help for anxiety or depression. So with this big shift in emergency department utilization and the need for more mental health services, we wanted to see if there was a discrepancy or some change in the ER wait times for people who had psychiatric complaints versus non-psychiatric complaints. So that's our primary objective here. We also had a secondary objective of looking at specific psychiatric complaints and seeing if they had increased or changing wait times based on what they're presenting with exactly. We also looked at the region that they were presenting to see if there's a certain region that had higher or lower wait times for people with psychiatric conditions. To do all this research, we used the National Hospital Ambulatory Medical Care Survey. It's published by the CDC every year. We used their data sets from 2019 to 2021, and they collate data from different hospitals, kind of a representative sample of emergency departments from across the nation. And they publish the type of provider, seeing the time it took them to get to a triage, to see a provider, as well as the ICD-10 code, which was attached to their chart. And that's what we used to see if they had a mental health complaint or a non-mental health complaint was the ICD-10 code. All the mental health complaints are ICD-10 code F category. So that's what we used to compare to all other complaints. We also looked at the average wait times, which was also provided by the data set, as well as the region that they were in, broken down by specific F code subcategories to determine exactly what their diagnosis was. So I'll start with the sort of unremarkable results from the paper, which was that there was no significant difference from this timeframe between psychiatric and non-psychiatric conditions. You'll see kind of in this big chart shows average wait time in minutes by month here. And the red line here is psychiatric complaints. So you'll see there's a couple areas where it comes out of this 95% confidence interval of all cause ED visits, but overall the P value is only 0.57. So there's no significant difference overall. There was also no significant increase or decrease in the wait times over this time period for either psychiatric or non-psychiatric complaints. So it didn't increase overall or decrease. There's no significant change over the time period. Some of the interesting results we had though from this paper is that when we looked at it by region at the emergency department that they were visiting, those in the Northeast had significantly longer wait times if they had a psychiatric complaint versus non-psychiatric complaint. You'll see here, the left bars are non-psychiatric complaints and the right bars or the purple bars are psychiatric ones. It was significantly different in the Northeast here and then no significant change in any of the other regions. When we broke it down by F code subcategories, you'll see the F20 to 29 had significantly prolonged wait times, about average of 50 minutes compared to C20s and 30s in the other groups. And we looked at what these F20 to 29 group represents as people who presented with psychosis or schizophrenia and the like. So the purpose of this paper is to identify sort of what the problem is. If there is a problem that needs to be addressed, then kind of lead onto future research projects which could kind of identify how that can be addressed. So we did see that there is a significant discrepancy in wait times among people with psychiatric conditions in the Northeast and that's all psychiatric conditions, as well as in all regions, people who have schizophrenia, psychosis have increased wait times. So some sort of initiatives that can maybe help ameliorate some of these discrepancies is triage protocols for people who have come in with psychiatric complaints, who come in with psychosis or maybe increased education. Maybe if the provider doesn't know how to best address schizophrenia, psychosis, maybe they'll be more likely to prolong their time to see that patient. So this research kind of sets up for future quality improvement projects in that regard, sort of to just identify where the problem lies and is present. So here are my references. I know they're kind of covered by my face here in the bottom right, but I wanted to thank you for giving me the last five minutes to tell you about my research and I look forward to seeing most of you at OMED online. Thank you.

emergency room wait times

psychiatric conditions

COVID-19 impact

CDC data

quality improvement