Examining the Emergency Department Care Experiences of Equity-Deserving Groups Using an Intersectional Lens.

Abstract

Equity-deserving groups (EDGs) face societal barriers, including healthcare barriers within the emergency department (ED), due to discrimination. Most patient-care experience research considers only a single-axis perspective, neglecting multifaceted impacts of discrimination, or intersectionality. Detailed is a secondary analysis of a mixed-methods, cross-sectional study conducted at the Kingston Health Sciences Centre (KHSC) between June and August 2021. A quantitative analysis was conducted to identify differences between participants who did not identify as equity-deserving (controls), and those who identified with 1, 2, or 3 EDGs, respectively. The research team conducted thematic analysis on the shared micronarratives to contextualize the quantitative results. The research team also held focus groups with community partners that served EDGs to gain their insights on study findings and add their perspectives to the captured themes. Comparing 1973 individuals belonging to none, 1, 2, or 3 EDGs revealed significant differences in patient-perceived attention to their needs (<i>P</i> < .001), patient-control in health care decision-making (<i>P</i> = .001), and whether quality medical care or experiencing kindness/respect was more important (<i>P</i> = .003). Three themes were identified: <i>stigma and discrimination</i>, <i>lack of patient-centered care</i>, and <i>need for improved patient-provider communication</i>. The study's findings contribute to a sparse body of evidence on EDG-care experiences in the ED through an intersectionality lens. Future research efforts should evaluate the complex interactions of specific EDG memberships to improve care experiences.