• Yannis K Valtis, Kristen E Stevenson, Emily M Murphy, Jennifer Y Hong, Mohsin Ali, Sejal Shah, Adrienne Taylor, Karthik Sivashanker, and Evan M Shannon.
• Department of Medicine, Brigham and Women's Hospital, 75 Francis St, Boston, MA, 02115, USA. yvaltis@bwh.harvard.edu.
• J Gen Intern Med. 2023 Jan 1; 38 (1): 303530-35.

BackgroundSecurity emergency responses (SERs) are utilized by hospitals to ensure the safety of patients and staff but can cause unintended morbidity. The presence of racial and ethnic inequities in SER utilization has not been clearly elucidated.ObjectiveTo determine whether Black and Hispanic patients experience higher rates of SER and physical restraints in a non-psychiatric inpatient setting.DesignRetrospective cohort study.ParticipantsAll patients discharged from September 2018 through December 2019.ExposureRace and ethnicity, as reported by patients at time of registration.Main OutcomesThe primary outcome was whether a SER was called on a patient. The secondary outcome was the incidence of physical restraints among patients who experienced a SER.Key ResultsAmong 24,212 patients, 18,755 (77.5%) patients identified as white, 2,346 (9.7%) as Black, and 2,425 (10.0%) identified with another race. Among all patients, 1,827 (7.6%) identified as Hispanic and 21,554 (89.0%) as non-Hispanic. Sixty-six (2.8%) Black patients had a SER activated during their first admission, compared to 295 (1.6%) white patients. In a Firth logit multivariable model, Black patients had higher adjusted odds of a SER than white patients (adjusted odds ratio (aOR) 1.37 [95% confidence interval: 1.02, 1.81], p = 0.037). Hispanic patients did not have higher odds of having a SER called than non-Hispanic patients. In a Poisson multivariable model among patients who had a SER called, race and ethnicity were not found to be significant predictors of restraint.ConclusionBlack patients had higher odds of a SER compared to white patients. No significant differences were found between Hispanic and non-Hispanic patients. Future efforts should focus on assessing the generalizability of these findings, the underlying mechanisms driving these inequities, and effective interventions to address them.© 2022. The Author(s), under exclusive licence to Society of General Internal Medicine.

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