Study Suggests Increased Risk of Restraint Use in Black Patients in the Emergency Setting

Patient visits at Massachusetts General Hospital (2016-2018).

study published in the most recent issue of Academic Emergency Medicine (AEM), journal showed an increased risk of restraint use in Black patients compared with white patients in the emergency setting. The risk was not increased in other races or Hispanic/Latino ethnicity.

The lead author of the single-center study is Dr. Kristina Schnitzer MD, a psychiatrist in the Schizophrenia Clinical and Research Program at Massachusetts General Hospital and an instructor at Harvard Medical School. The findings of the study are discussed with two of the authors in episode 43 of AEM Early Access, a FOAMed podcast collaboration between the Academic Emergency Medicine Journal and Brown Emergency Medicine.

The increased risk of restraint was present in Black patients after controlling for other variables, including repeated visits, using a specialized regression technique. Concerning data also showed that 7-8 percent of all patients with psychosis or bipolar disorder, and six percent of all homeless patients were restrained. The study also identifies that there is an increased risk of patients to be restrained who are on public insurance or uninsured.

The study results warrant a careful examination of current practices and potential biases in utilization of restraint in emergency settings.

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