J Gen Intern Med. 2026 Jul 29. doi: 10.1007/s11606-026-10625-x. Online ahead of print.
ABSTRACT
BACKGROUND: Emergency departments (ED) provide timely care for acute conditions and serve as a vital safety net. Longer ED wait times are associated with worse health outcomes, but differences in ED wait times by patient language remain understudied.
OBJECTIVE: Examine differences in ED wait times between English and non-English language patients and its association with ED crowding.
DESIGN: Retrospective cohort study of ED visits at an academic medical center in 2023 and 2024.
PARTICIPANTS: 73,420 ED visits among adult patients not triaged to the highest acuity categories.
MAIN MEASURES: Wait times from triage to provider assignment by patient primary language were assessed via unadjusted analyses and generalized linear models adjusting for demographic, temporal, and system factors as well as patient comorbidities and chief complaint. Language was then interacted with ED census to assess for effect modification from ED crowding. Secondary outcomes were time from provider assignment to ED disposition and rates of left without being seen (LWBS).
KEY RESULTS: Patients with a primary non-English language waited on average 6.5 min (p < 0.001) or 8.4% longer than English-primary patients for an ED provider-a difference that persisted after statistical adjustment (6.6 min, p < 0.001). Cantonese, Spanish, Russian, and Toishanese language patients experienced statistically longer wait times than English language patients. With ED census, each 10 additional patients in the ED were associated with an adjusted 2.3 min (p = 0.02) longer differential wait time for non-English language patients. Despite these differences, rates of LWBS were significantly lower for non-English language patients in both unadjusted and adjusted analyses (p < 0.001).
CONCLUSIONS: Longer ED wait times for patients with a primary non-English language reflect a health inequity affecting a disadvantaged population. The degree of disparity widened as ED census increased. Health system and policy attention is needed to address ED crowding and other factors that could contribute to this disparity.
PMID:42527840 | DOI:10.1007/s11606-026-10625-x
