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Racial/Ethnic Disparities in Pain Treatment

Evidence From Oregon Emergency Medical Services Agencies

Kennel, Jamie MAS*,†,‡; Withers, Elizabeth MS; Parsons, Nate MS; Woo, Hyeyoung PhD

doi: 10.1097/MLR.0000000000001208
Original Articles
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Background: Despite the critical role that Emergency Medical Services (EMS) provides in the health care system, racial/ethnic treatment disparities in EMS remain relatively unexamined.

Objective: To investigate racial/ethnic treatment disparities in pain assessment and pain medication administration in EMS.

Research Design: A retrospective analysis was performed on 25,732 EMS encounters from 2015 to 2017 recorded in the Oregon Emergency Medical Services Information System using multivariate logistic regression models to examine the role of patient race/ethnicity in pain assessment and pain medication administration among patients with a traumatic injury.

Results: Hispanic and Asian patients were less likely to receive a pain assessment procedure and all racial/ethnic patients were less likely to receive pain medications compared with white patients. In particular, regarding the adjusted likelihood of receiving a pain assessment procedure, Hispanic patients were 21% less likely [95% confidence interval (CI), 10%–30%; P<0.001], Asian patients were 31% less likely (95% CI, 16%–43%; P<0.001) when compared with white patients. Regarding the adjusted likelihood of receiving any pain medications, black patients were 32% less likely (95% CI, 21%–42%; P<0.001), Hispanic patients were 21% less likely (95% CI, 7%–32%; P<0.01), and Asian patients were 24% less likely (95% CI, 1%–41%; P<0.05) when compared with white patients.

Conclusions: Racial/ethnic minorities were more likely to experience disadvantages in EMS treatment in Oregon. Hispanic and Asian patients who requested EMS services in Oregon for traumatic injuries were less likely to have their pain assessed and all racial/ethnicity patients were less likely to be treated with pain medications when compared with white patients.

*Oregon Institute of Technology, Wilsonville

Oregon Health and Science University

Portland State University, Portland, OR

The content and conclusions presented here are those of the authors and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS, or the US Government.

Supported by a grant from the Health Resources and Services Administration (HRSA) of the US Department of Health and Human Services (HHS) under the Medicare Rural Hospital Flexibility Program (H54RH00049).

The authors declare no conflict of interest.

Reprints: Hyeyoung Woo, PhD, Portland State University, Portland, OR 97207. E-mail: hyeyoung@pdx.edu.

Online date: September 13, 2019

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