Are racial disparities in ED analgesia improving? Evidence from a national database

Objective: Ethnic disparities in emergency department (ED) analgesic use have been noted previously; the purpose of this study was to determine if current ED practice has been altered subsequent to the widespread recognition of these inequalities. Methods: Using data from the National Hospital Ambulatory Care Survey, we analyzed ED analgesic treatment with respect to race for the complaints of headache (HA) and long bone fractures (LBF) for 1995 to 1999 (period A) and compared that with data for 2000 to 2003 (period B). We compared the use of any analgesics and opioids among blacks, whites, and Hispanics. Results: For both HA and LBF, improvements over time were noted in all 3 ethnic subgroups. A statistically significant increase was documented in the treatment of HA among Hispanics using any analgesia (71.3% vs 80.8%, P = .011). Although individual differences between the 2 periods in the LBF cohort were not statistically significant for any of the 3 ethnic groups, there was an overall improvement noted when combining all ethnicities: among all patients treated for LBF, 66% received some analgesic and 42.8% received opioid analgesia during period A vs 75% and 51%, respectively, during period B (all P <.001). Furthermore, in the latest study period, there were no differences in the frequency of analgesic administration for LBF with respect to race (blacks, 43%; whites, 48%; Hispanics, 43.8%; P > .1). Conclusion: There is evidence that previously described racial inequalities in analgesic use have decreased over time. (c) 2008 Elsevier Inc. All rights reserved.