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Ethnicity-Based Differences in Emergency Department Care of Patients with Heart Attack Symptoms

Principal Investigator: Dr. Martha Mackay

Status: Ongoing

When doctors and nurses use accepted guidelines for quickly treating patients who come to the emergency department (ED) with a possible heart attack, patients do better. Research shows that there are ethnicity-based differences in the symptoms these patients have, when and why they seek care, the treatments they receive, and how well they fare afterwards. There is also Canadian evidence that there may be ethnicity-based disparities in the care some patients receive, and it has been suggested that health professionals may unconsciously treat patients of different ethnic backgrounds differently. But it is not known if there is ethnic variation in the care given to Canadian patients with heart attack symptoms in the critical first hours after coming to an ED, or in their experiences of this care.

Dr. Martha Mackay and colleagues will collect information from the health records of patients who come to EDs with symptoms of heart attack. They will record events and times such as what provisional diagnosis is assigned to the patient, how often they receive pain medication, how long until certain tests are performed, and what treatments are offered. Researchers will also collect information about things that might affect delivery of care, e.g., the number of doctors and nurses who are on duty. Patients will also complete a short questionnaire about their reasons for coming to the hospital, how long they waited before coming and why, and what their experience in the ED was like.

Researchers will review this information to see if there are ethnicity-based differences in the care received by patients with heart attack symptoms. Their findings could identify important disparities, which could in turn inform future projects to correct these disparities, for example, education of health professionals about ethnic differences in ideas of health and illness.


Mackay MH, Ratner PA, Veenstra G, Scheuermeyer FX, Grubisic M, Ramanathan K, Murray C, Humphries KH. Racism is not a factor in door-to-ECG times of patients with symptoms of acute coronary syndrome: A prospective, observational study. Acad Emerg Med. 2018 Sep 17 epub ahead of print.

Health research in the heart of Vancouver