Racial Disparities in Opioid Administration

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A recent study in JAMA Pediatrics brings to light racial differences in analgesia administration among children with appendicitis.

Preface
In a summer marked by racial tension and violence, it is comforting to see the emergency department as a healthcare haven where all are treated equally, regardless of race, creed or ability to pay. Perhaps in your emergency department this is the reality. However, a 2015 study in JAMA Pediatrics tells a different story, and suggests that subconsious bias may be more prevalent than we realize.

Study
Racial Disparities in Pain Management of Children With Appendicitis in Emergency Departments

Authors
Monika K. Goyal, MD, MSCE Nathan Kuppermann, MD, MPH Sean D. Cleary, PhD, MPH Stephen J. Teach, MD, MPH James M. Chamberlain, MD

Objective
To evaluate racial differences in analgesia administration, and particularly opioid administration, among children diagnosed as having appendicitis.

Design, Setting, and Participants
Repeated cross-sectional study of patients aged 21 years or younger evaluated in the emergency department who had an International Classification of Diseases, Ninth Revision diagnosis of appendicitis, using the National Hospital Ambulatory Medical Care Survey from 2003 to 2010. Study authors calculated the frequency of both opioid and nonopioid analgesia administration using complex survey weighting. They then performed multivariable logistic regression to examine racial differences in overall administration of analgesia, and specifically opioid analgesia, after adjusting for important demographic and visit covariates, including ethnicity and pain score.

Main Outcomes and Measures
Receipt of analgesia administration (any and opioid) by race.

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