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On the basis of the results of the present study, a study protocol has been developed for the study of healthcare disparities in EDs. The protocol provides the researcher with a thorough and specific checklist to guide study design, data collection and data analysis. Knowledge of the variability within a given healthcare system and the impact of health disparities on healthcare utilization in the ED is crucial for the design of the study. With knowledge of the variability, the research team can adapt the study design for ED use. The protocol may be used for broader healthcare disparities research in EDs.
The protocol requires that an ED-specific electronic record be used. The e-record must be structured to allow for the creation of an ED-specific presenting complaint list. A list for each ED and each healthcare facility is needed. The information in the electronic record must be readily available. For other EDs, the list can be adapted on the basis of the instruments used in this study. The researchers must reach an agreement on the presenting complaint list. They must decide on the duration of the electronic record and on how to link the presenting complaint list with medical records. The protocol specifies the data collection of presenting complaints and medical records as well as the electronic data collection. The protocol also specifies the data analysis. The study plan is consistent with the protocol and provides data on the medical services used and the presenting complaints of patients in the ED. Medical records and electronic data can be linked using the ED-specific electronic record. ED-specific data provide information on the variety of healthcare services used in the ED.
The protocol is not suited for studies of ED patients. For such studies, individual patient electronic records or registration data are needed. The protocol is not suited for studies on determinants of healthcare disparities. For these studies, a complete healthcare system is needed.
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