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Abstract：
Much is known about racial and ethnic disparities in receipt of opioids for pain in emergency departments. Less is known about such disparities in the evaluation and management of pain in the outpatient setting.
Using the nationally representative National Ambulatory Medical Care Survey (NAMCS), we estimated disparities in visit time with physicians and opioid receipt in the outpatient setting. We focused on patients whose reason for visiting was abdominal pain or back pain. Our sample included 4,764 white patients, 692 black patients, and 682 Hispanic patients.
Back pain visits of Hispanic patients lasted 1.6 fewer minutes than those of white non-Hispanic patients (P = 0.04 for the difference). Black patients were 6.0% less likely than white patients to receive opioids for abdominal pain (P = 0.04 for the difference) and 7.1% less likely than white patients to receive opioids for back pain (P = 0.046 for the difference). Hispanic patients were 6.3% less likely than white patients to receive opioids for abdominal pain (P = 0.003 for the difference) and 14.8% less likely than white patients to receive opioids for back pain (P < 0.001 for the difference). Hispanic patients were more likely than white patients to receive nonopioids instead of opioids for both abdominal pain and back pain. Differences in opioid receipt did not narrow during the examined time period.
Identifying causes of racial and ethnic disparities in the evaluation and treatment of pain in the outpatient setting is important to improving the health and function of patients.
Using the nationally representative National Ambulatory Medical Care Survey (NAMCS), we estimated disparities in visit time with physicians and opioid receipt in the outpatient setting. We focused on patients whose reason for visiting was abdominal pain or back pain. Our sample included 4,764 white patients, 692 black patients, and 682 Hispanic patients.
Back pain visits of Hispanic patients lasted 1.6 fewer minutes than those of white non-Hispanic patients (P = 0.04 for the difference). Black patients were 6.0% less likely than white patients to receive opioids for abdominal pain (P = 0.04 for the difference) and 7.1% less likely than white patients to receive opioids for back pain (P = 0.046 for the difference). Hispanic patients were 6.3% less likely than white patients to receive opioids for abdominal pain (P = 0.003 for the difference) and 14.8% less likely than white patients to receive opioids for back pain (P < 0.001 for the difference). Hispanic patients were more likely than white patients to receive nonopioids instead of opioids for both abdominal pain and back pain. Differences in opioid receipt did not narrow during the examined time period.
Identifying causes of racial and ethnic disparities in the evaluation and treatment of pain in the outpatient setting is important to improving the health and function of patients.
摘要：
关于急诊科因疼痛而接受阿片类药物的种族和族裔差异，人们了解很多。对门诊疼痛评估和管理中的这种差异知之甚少。
使用具有全国代表性的全国门诊医疗调查(NAMCS)，我们估计了门诊就诊时间与医师和接受阿片类药物治疗的差异.我们专注于就诊原因为腹痛或背痛的患者。我们的样本包括4,764名白人患者，692名黑人患者,和682名西班牙裔患者。
西班牙裔患者的背痛就诊时间比白人非西班牙裔患者少1.6分钟（差异P=0.04）。黑人患者接受阿片类药物治疗腹痛的可能性比白人患者低6.0％（差异P=0.04），而接受阿片类药物治疗背部疼痛的可能性比白人患者低7.1％（差异P=0.046）。西班牙裔患者接受阿片类药物治疗腹痛的可能性比白人患者低6.3%(差异P=0.003)，接受阿片类药物治疗背痛的可能性比白人患者低14.8%(差异P<0.001)。西班牙裔患者比白人患者更有可能接受非阿片类药物而不是阿片类药物治疗腹痛和背痛。在检查的时间段内，阿片类药物的接收差异并未缩小。
确定门诊疼痛评估和治疗中种族和民族差异的原因对于改善患者的健康和功能很重要。
使用具有全国代表性的全国门诊医疗调查(NAMCS)，我们估计了门诊就诊时间与医师和接受阿片类药物治疗的差异.我们专注于就诊原因为腹痛或背痛的患者。我们的样本包括4,764名白人患者，692名黑人患者,和682名西班牙裔患者。
西班牙裔患者的背痛就诊时间比白人非西班牙裔患者少1.6分钟（差异P=0.04）。黑人患者接受阿片类药物治疗腹痛的可能性比白人患者低6.0％（差异P=0.04），而接受阿片类药物治疗背部疼痛的可能性比白人患者低7.1％（差异P=0.046）。西班牙裔患者接受阿片类药物治疗腹痛的可能性比白人患者低6.3%(差异P=0.003)，接受阿片类药物治疗背痛的可能性比白人患者低14.8%(差异P<0.001)。西班牙裔患者比白人患者更有可能接受非阿片类药物而不是阿片类药物治疗腹痛和背痛。在检查的时间段内，阿片类药物的接收差异并未缩小。
确定门诊疼痛评估和治疗中种族和民族差异的原因对于改善患者的健康和功能很重要。
