Race seems to be at play in the emergency room (ER) for children being treated for acute appendicitis. A study shows black children are less likely to receive analgesia, specifically opioid, than white children.
Lead study author Dr. Monika Goyal of the Children's National Health System in Washington shares that less than 60 percent of the children in the ER get painkillers. She stresses the striking racial differences when it comes to patients who get opioid for treatment.
Goyal and her team used survey data from 2003 to 2010, which covered over 1 million patients who were 21 years old and younger. The patients were all treated in the ER for the same condition. The study revealed that only 57 percent were given analgesia. Around 41 percent were given opioid to treat the severe pain, with 12 percent of them being black patients.
Past studies show racial disparity in managing adult patients, particularly in the emergency department. This study specifically looked into the emergency room treatment of young patients.
Boston Children's Hospital's Dr. Eric W. Fleegler notes that Goyal used data gathered in 2003 to 2010. There is hope that conditions have improved and that results might yield improvement if the study used data from 2011 onwards.
Fleegler's colleague, Dr. Neil L. Schechter, believes that pain level varies from patient to patient. Symptom duration and inflammation level also play a role in pain management, but the fact remains that analgesics are prescribed for patients being treated for acute appendicitis, regardless of race. Each patient has the right to ensure that he or she is being treated equally. Fleegler and Schechter highlight the importance of patient-centric pain management.
"Really understanding racial disparities in healthcare is extremely important," said Goyal. The study is not meant to distinguish why racial disparity exists in pain management. External factors, such as institutional practices and insurance providers, may have played a role. Experts agree the unconscious bias and fear of opioid medication contributed to the results.
Putting these racial disparities under the spotlight could result in interventions for better pain management with health equity as the goal. Acute appendicitis is a very painful surgery condition for both adults and children. Pain management should be independent of racial preference, insurance coverage, parental practices and socioeconomic status, especially in the emergency room.
