Racial Disparity in the ER? Black Children Less Likely to Receive Pain Meds for Appendicitis, Study Says

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Bawa_200915According to a new study that examines hospital practices, black children are less likely to receive opioid painkillers to treat appendicitis than white children. Study findings were recently reported online in JAMA Pediatrics.

The study was led by Dr. Monika K. Goyal of the Children’s National Health System and included data from the National Hospital Ambulatory Medical Care Survey from 2003 to 2010. Approximately one million patients age 21 and under were evaluated in the emergency room for diagnosis of appendicitis. Children had a median age of 13.5 years and the study population was 86.6% white and 68.4% male.

The study took into consideration a number of factors, such as pain score, insurance status, sex, and age. The research team discovered that 12% of black children with appendicitis were treated with opioid analgesia, while approximately 34% of white children with appendicitis received the same treatment.

Study results were similar even when adjusting for pain score. Approximately 25% of black children in severe pain were treated with opioids for appendicitis pain compared to nearly 60% of white children. Furthermore, 60% of white children were likely to receive opioids when they complained about moderate pain, compared to 15% of black children.

Authors suggest that potential limitations include patients’ possibly declining treatment with opioid analgesia as well as misclassification errors surrounding medication data.

Still, results are surprising considering appendicitis is regarded as a painful surgical condition. Goyal suggests that understanding racial disparity is an important topic for further analysis.

Sources for Today’s Article:
Goyal, M.K., et al., “Racial Disparities in Pain Management of Children With Appendicitis in Emergency Departments,” JAMA Pediatrics, published online September 14, 2015. doi:10.1001/jamapediatrics.2015.1915.
Doyle, K., “Black children less likely to get pain drugs for appendicitis,” Reuters web site, September 14, 2015; http://www.reuters.com/article/2015/09/14/us-health-racialbias-kids-pain-idUSKCN0RE1OE20150914.
Walker, M., “Race May Play a Role in Treating Kids’ Pain—Black children with appendicitis less likely to receive opioid painkillers,” MedPageToday web site, last updated September 16, 2015; http://www.medpagetoday.com/Pediatrics/GeneralPediatrics/53565.

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