Are There Racial Disparities in US Emergency Department Pain Management?

Minorities were 22% to 30% less likely to receive any pain medications compared with white patients.

Minorities are less likely to receive analgesic medications for abdominal pain in US emergency departments (EDs), according to research published in Medical Care.

“This analysis, which uses data from EDs from across the country, found that minorities experience significant disparities with regard to the receipt of analgesic medications for abdominal pain,” said senior author Adil H. Haider, MD, MPH, FACS, of Brigham and Women’s Hospital in Boston in a press release. “Black patients had the greatest increased odds of undertreatment for pain among the groups considered. Black and Hispanic patients experienced prolonged ED lengths of stay and were less likely to be hospitalized for their ailments.”

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The researchers analyzed data from the Centers for Disease Control and Prevention (CDC)’s National Hospital Ambulatory Medical Care Survey of 6710 adults with nontraumatic acute abdominal pain who were seen at 350 emergency departments in the United States between 2006 and 2010. Approximately 61% of patients (n=4106) were non-Hispanic white, 20.1% (n=1352) were non-Hispanic black, 14.0% (n=939) were Hispanic, and 4.7% (n=313) were other racial/ethnic groups.

Overall, white patients were more likely to receive pain medications compared with the other groups: 56.8% of white patients received analgesics compared with 52.8% of Hispanics patients, 50.9% of black patients, and 46.6% of patients of other race or ethnicities. After adjusting for other factors, minorities were 22% to 30% less likely to receive any pain medications compared with white patients.

Despite reports of severe pain at nearly the same frequency from white patients (58.4%) and black patients (59.7%) (P=0.830), white patients received narcotic analgesics more frequently than the other groups. 44.2% of white patients received narcotics compared with 39.5% of black patients, 38.5% of Hispanic patients, and 35.8% of other patients. After adjustment for other factors, minorities were 17% to 30% less likely to receive narcotic analgesics.