Annals of Emergency Medicine, Volume 74, November 2019,
Study objective: We examine racial and ethnic differences in opioid prescribing and dosing for long bone fractures at emergency department (ED) discharge. Methods: We conducted an electronic health records–based cross-sectional study of adults with long bone fractures who presented to the ED across 22 sites from a health care delivery system (2016 to 2017). We examined differences in opioid prescribing at ED discharge and, among patients with a prescription, differences in opioid dosing (measured as morphine milligram equivalents) by race/ethnicity, using regression modeling with statistical adjustment for patient, fracture, and prescriber characteristics. Results: A total of 11,576 patients with long bone fractures were included in the study; 64.4% were non-Hispanic white; 16.4%, 7.3%, 5.8%, and 5.1%, respectively, were Hispanic, Asian, black, and of other or unknown race; and 65.6% received an opioid at discharge. After adjusting for other factors, rates of opioid prescribing were not different by race/ethnicity; however, among patients with an opioid prescription, total morphine milligram equivalent units prescribed were 4.3%, 6.0%, and 8.1% less for Hispanics, blacks, and Asians relative to non-Hispanic whites. Conclusion: Racial and ethnic minority groups with long bone fractures receive similar frequencies of opioid prescriptions at discharge, with a small potency difference. How this affects pain relief and why it happens is unclear.
Adult; Analgesics, Opioid; Article; Asian; Black Person; California; Caucasian; Clinical Practice; Complication; Cross-Sectional Studies; Cross-sectional Study; Electronic Health Record; Emergency Service, Hospital; Emergency Ward; Ethnic Difference; Ethnic Group; Ethnic Groups; Female; Fracture; Fractures, Bone; Health Care Disparity; Health Care System; Health Disparity; Health Status Disparities; Hispanic; Hospital Discharge; Hospital Emergency Service; Human; Humans; Long Bone; Major Clinical Study; Male; Middle Aged; Minority Group; Minority Groups; Narcotic Analgesic Agent; Opiate; Pain, Postoperative; Patient Discharge; Postoperative Pain; Practice Patterns, Physicians'; Prescription; Priority Journal; Race Difference; Regression Analysis; Young Adult; North America