OBJECTIVE: To determine if race/ethnicity-based differences exist in the management of pediatric abdominal pain in emergency departments (EDs). METHODS: Secondary analysis of data from the 2006-2009 National Hospital Ambulatory Medical Care Survey regarding 2298 visits by patients ≤ 21 years old who presented to EDs with abdominal pain. Main outcomes were documentation of pain score and receipt of any analgesics, analgesics for severe pain (defined as ≥ 7 on a 10-point scale), and narcotic analgesics. Secondary outcomes included diagnostic tests obtained, length of stay (LOS), 72-hour return visits, and admission. RESULTS: Of patient visits, 70.1% were female, 52.6% were from non-Hispanic white, 23.5% were from non-Hispanic black, 20.6% were from Hispanic, and 3.3% were from "other" racial/ethnic groups; patients' mean age was 14.5 years. Multivariate logistic regression models adjusting for confounders revealed that non-Hispanic black patients were less likely to receive any analgesic (odds ratio [OR]: 0.61; 95% confidence interval [CI]: 0.43-0.87) or a narcotic analgesic (OR: 0.38; 95% CI: 0.18-0.81) than non-Hispanic white patients (referent group). This finding was also true for non-Hispanic black and "other" race/ethnicity patients with severe pain (ORs [95% CI]: 0.43 [0.22-0.87] and 0.02 [0.00-0.19], respectively). Non-Hispanic black and Hispanic patients were more likely to have a prolonged LOS than non-Hispanic white patients (ORs [95% CI]: 1.68 [1.13-2.51] and 1.64 [1.09-2.47], respectively). No significant race/ethnicity-based disparities were identified in documentation of pain score, use of diagnostic procedures, 72-hour return visits, or hospital admissions. CONCLUSIONS: Race/ethnicity-based disparities exist in ED analgesic use and LOS for pediatric abdominal pain. Recognizing these disparities may help investigators eliminate inequalities in care.
OBJECTIVE: To determine if race/ethnicity-based differences exist in the management of pediatric abdominal pain in emergency departments (EDs). METHODS: Secondary analysis of data from the 2006-2009 National Hospital Ambulatory Medical Care Survey regarding 2298 visits by patients ≤ 21 years old who presented to EDs with abdominal pain. Main outcomes were documentation of pain score and receipt of any analgesics, analgesics for severe pain (defined as ≥ 7 on a 10-point scale), and narcotic analgesics. Secondary outcomes included diagnostic tests obtained, length of stay (LOS), 72-hour return visits, and admission. RESULTS: Of patient visits, 70.1% were female, 52.6% were from non-Hispanic white, 23.5% were from non-Hispanic black, 20.6% were from Hispanic, and 3.3% were from "other" racial/ethnic groups; patients' mean age was 14.5 years. Multivariate logistic regression models adjusting for confounders revealed that non-Hispanic black patients were less likely to receive any analgesic (odds ratio [OR]: 0.61; 95% confidence interval [CI]: 0.43-0.87) or a narcotic analgesic (OR: 0.38; 95% CI: 0.18-0.81) than non-Hispanic white patients (referent group). This finding was also true for non-Hispanic black and "other" race/ethnicity patients with severe pain (ORs [95% CI]: 0.43 [0.22-0.87] and 0.02 [0.00-0.19], respectively). Non-Hispanic black and Hispanic patients were more likely to have a prolonged LOS than non-Hispanic white patients (ORs [95% CI]: 1.68 [1.13-2.51] and 1.64 [1.09-2.47], respectively). No significant race/ethnicity-based disparities were identified in documentation of pain score, use of diagnostic procedures, 72-hour return visits, or hospital admissions. CONCLUSIONS: Race/ethnicity-based disparities exist in ED analgesic use and LOS for pediatric abdominal pain. Recognizing these disparities may help investigators eliminate inequalities in care.
Authors: Romana Hasnain-Wynia; Raymond Kang; Mary Beth Landrum; Christine Vogeli; David W Baker; Joel S Weissman Journal: J Health Care Poor Underserved Date: 2010-05
Authors: Esther H Chen; Frances S Shofer; Anthony J Dean; Judd E Hollander; William G Baxt; Jennifer L Robey; Keara L Sease; Angela M Mills Journal: Acad Emerg Med Date: 2008-05 Impact factor: 3.451
Authors: James Ducharme; Paula Tanabe; Peter Homel; James R Miner; Andrew K Chang; Jacques Lee; Knox H Todd Journal: Am J Emerg Med Date: 2008-10 Impact factor: 2.469
Authors: Sunitha V Kaiser; Renee Asteria-Penaloza; Eric Vittinghoff; Glenn Rosenbluth; Michael D Cabana; Naomi S Bardach Journal: Pediatrics Date: 2014-04-21 Impact factor: 7.124
Authors: Amy L Drendel; David C Brousseau; T Charles Casper; Lalit Bajaj; Evaline A Alessandrini; Robert W Grundmeier; James M Chamberlain; Monika K Goyal; Cody S Olsen; Elizabeth R Alpern Journal: Pain Med Date: 2020-09-01 Impact factor: 3.750
Authors: Heather G Zook; Nathaniel R Payne; Susan E Puumala; Katherine M Ziegler; Anupam B Kharbanda Journal: Pediatr Emerg Care Date: 2019-03 Impact factor: 1.454
Authors: Monika K Goyal; Tiffani J Johnson; James M Chamberlain; Lawrence Cook; Michael Webb; Amy L Drendel; Evaline Alessandrini; Lalit Bajaj; Scott Lorch; Robert W Grundmeier; Elizabeth R Alpern Journal: Pediatrics Date: 2020-04-20 Impact factor: 7.124
Authors: Monika K Goyal; Nathan Kuppermann; Sean D Cleary; Stephen J Teach; James M Chamberlain Journal: JAMA Pediatr Date: 2015-11 Impact factor: 16.193