Racial-Ethnic Disparities in Opioid Utilization for Emergent Pain: A Nationally Representative Cohort Study
Digital Document
Document
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http://hdl.handle.net/11134/20002:860700017
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Persons
Creator (cre): Kassam, Jameel
Major Advisor (mja): Ungemack, Jane
Associate Advisor (asa): Rhee, Greg
Associate Advisor (asa): Mehta, Tapan
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Title |
Title
Title
Racial-Ethnic Disparities in Opioid Utilization for Emergent Pain: A Nationally Representative Cohort Study
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Origin Information
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Parent Item
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Resource Type
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Digital Origin |
Digital Origin
born digital
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Description |
Description
Introduction: public health surveillance data has historically shown that minority patients are more frequently denied opioids for conditions warranting their use, such as bone fractures and acute abdominal pain. Conversely, the overutilization of narcotic analgesics for conditions more amenable to non-narcotic alternatives has adversely affected non-Hispanic whites (NHWs), such as migraine headaches and acute lower back pain. Methods: We conducted retrospective analysis on a cohort of patients selected from the 2016-2019 National Hospital Ambulatory Medical Care Survey (NHAMCS). All emergency department (ED) visits made by patients aged 10-65 years with ICD-10 diagnostic codes corresponding to bone fractures, acute abdominal pain, primary headache disorder, or acute lower back pain from 2016 to 2019 were included. We constructed three minority race-ethnicity patient cohorts: NHW non-Hispanic black (NHB), and Hispanic. Results: From 2016 through 2019 there was an unweighted total of 9,913 documented ED visits involving patients with a reported race/ethnicity representing a weighted sample size 11,280,125 NHW patients, 4,110,518 NHB patients, and 2,994,094 Hispanic patients. Hispanic patients were ~40% less likely to receive narcotic-level analgesia for either bone fractures (95% CI: 0.37-0.85) or acute abdominal pain (95% CI: 0.37-0.85), although this association was not present after adjusting for all significant covariates (Table 5). Similarly, NHBs were ~40% less likely to receive opioids for acute abdominal pain than NHWs prior to (95% CI: 0.47-0.68) and after (95% CI: 0.48-0.75) adjustment for covariates. NHBs were 41% less likely to be inappropriately provided narcotics for benign acute low back pain relative to NHW patients prior to adjusting for covariates (95% CI: 0.44-0.77). By contrast, Hispanics were 50% more likely to inappropriately receive opioids for acute lower back pain compared with NHWs after adjusting for covariates (95% CI: 1.07-2.12). NHBs and Hispanics were given opioids 21% and 28% less frequently for acute lower back pain respectively prior to adjustment for selected baseline characteristics. Conclusion: After adjusting for other demographic and patient factors, NHBs were less likely to receive narcotics for acute abdominal pain compared to NHWs. Relative to NHWs. Hispanics were more likely to get opioids for acute lower back pain instead of nonopioids agents.
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Genre
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Organizations
Degree granting institution (dgg): University of Connecticut
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Use and Reproduction |
Use and Reproduction
These Materials are provided for educational and research purposes only.
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Degree Name |
Degree Name
Master of Public Health
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Degree Level |
Degree Level
Master
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Degree Discipline |
Degree Discipline
Public Health
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Local Identifier |
Local Identifier
S_24333279
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