Pain Treatment Disparities in Emergency Department Based on Race

Pain management treatment in US emergency room departments may vary depending on the race of the patient, according to a study published in Medical Care.

Researchers from Brigham and Women’s Hospital in Boston analyzed CDC data from 2006 — 2010 from patients with acute abdominal pain in order to evaluate racial or ethnicity-based differences in emergency department analgesic pain management among a national sample. The patients were all over the age of 18 years and were diagnosed using the same standard for nontraumatic acute abdominal pain as defined by the American Association for the Surgery of Trauma. The researchers gathered data about race, ethnicity, analgesic administration, emergency department wait time, number of diagnostic tests, and other inpatient admission information.

The researchers reviewed 6,710 emergency department visits overall, of which 61 percent were from non Hispanic white patients, 20 percent from non-Hispanic black patients, 14 percent Hispanic patients, and about 5 percent of patients from other racial groups. Non-Hispanic black patients and patients in the other racial group had between 22 and 30 percent lower risk adjusted odds of receiving analgesic treatment compared to non Hispanic white patients. Those groups had between 17 and 30 percent lower risk adjusted odds of receiving narcotic analgesic treatment.

The researchers also found that associations persisted for patients who had moderate to severe pain, but were insignificant for patients in mild pain.

“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,” senior author Dr. Adil H. Haider explained in a press release. “Black patients had the greatest increased odds of under treatment for pain among the groups considered. Black and Hispanic patients experienced prolonged emergency department lengths of stay and were less likely to be hospitalized for their ailments.”

The study authors believe that the root causes of racial and ethnic differences in pain management must be identified, because these disparities are “endemic in health care settings,” Haider continued. “It is essential that we as a medical community work to ensure that every patient receive unbiased empathy and the highest standard of care, regardless of his/ her racial heritage.”