Individual Patient Sociodemographic Characteristics Are Associated With Waiting Time to Physician Assessment in Seven Swedish Emergency Departments: An Observational 5-Year Cohort Study of Emergency Department Visits in the Stockholm Region.

Objectives: Emergency department (ED) inequities in access, treatment, and flow have been reported, but equity in the ED remains understudied. This study aimed to determine the association between patients' sociodemographic characteristics and waiting times to physician assessment in the ED. Methods: This was an observational study on 1,744,301 ED visits by 884,228 patients, using registry data from all 7 EDs in the Stockholm region, Sweden, 2012 to 2016. Exposures were age, sex, educational level, and birth region. A multivariable generalized linear regression model with penalized quasi-likelihood, adjusted for triage priority, chief complaint, admission status, crowding level, shift, weekend, and hospital site, was used to analyze the associations. Results: In the adjusted model, women waited 1% longer than men (95% CI, 1%-2%). Patients aged 60 to 79 years waited 8% longer than those aged 18 to 39 years (95% CI, 7%-8%). Those born outside the EU or Nordic countries waited 6% longer than Swedish-born patients (95% CI, 6%-6%). Patients with less than 10 years of education waited 2% longer than those with over 12 years (95% CI, 1%-2%). Conclusion: Waiting time to a physician was independently associated with age, sex, education, and birth region. Individuals who were older than 60 years and born outside Europe were the strongest predictors of longer waits. These findings suggest disparities not explained by medical need. As longer waits are linked to worse outcomes, further research is needed to understand mechanisms and reduce inequities in emergency care.