Check out this study from Johnson et al. in Pediatrics. In “Association of Race and Ethnicity With Management of Abdominal Pain in the Emergency Department” the authors reviewed NHAMCS data and noted that patients who were categorized as non-Hispanic black were less likely to receive any analgesic (odds ratio

[OR]: 0.61; 95% CI: 0.43-0.87) or a narcotic analgesic (OR: 0.38; 95% CI: 0.18-0.81) than non-Hispanic white patients. They also noted that 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) were also less likely to get pain meds. Non-Hispanic black and Hispanic patients were also more likely to have a prolonged length of stay than white patients (ORs [95% CI]: 1.68 [1.13-2.51] and 1.64 [1.09-2.47], respectively).

There were no differences in documentation of pain score, use of diagnostic procedures, 72-hour return visits, or hospital admissions.

What did I take home from this study? Well, I think that it’s pretty obvious – treat everyone the same. Though a large (albeit robust) database does have some drawbacks in that it can’t capture all of the minutiae of these visits, this is still an interesting look into how Emergency Departments manage abdominal pain.

Check it out here and on PubMed here