Department of Public Health Sciences (SS Lopes, L Shi, LB Sivaraj, K Truong, L Rolke), Clemson University, Clemson, SC.
Department of Public Health Sciences (SS Lopes, L Shi, LB Sivaraj, K Truong, L Rolke), Clemson University, Clemson, SC.
Acad Pediatr. 2022 May-Jun;22(4):631-639. doi: 10.1016/j.acap.2022.02.021. Epub 2022 Mar 4.
To examine dispensed opioid prescription patterns for limb fractures across racial/ethnic groups in a pediatric population.
We used South Carolina's Medicaid claims data 2000 to 2018 for pediatric limb fracture cases (under age 19) discharged from the emergency department. The key independent variable was the child's race/ethnicity. The outcomes were: 1) whether the patient had a dispensed opioid prescription; and 2) whether dispensed opioid supply was longer than 5 days among cases with any dispensed opioid prescriptions. Logistic regression models were used to test the association between race/ethnicity and the outcomes. Covariates included age-at-service, gender, service year, and having multiple fracture injuries.
Compared with non-Hispanic White cases (NHW), the odds of receiving dispensed opioid prescriptions were lower for cases of non-Hispanic Black (NHB) (OR = 0.73; 95% confidence interval [CI]: 0.71, 0.75), Asian (OR = 0.69; CI: 0.53, 0.90), Other/Unknown (OR = 0.86; CI: 0.80, 0.92), and Hispanic (OR = 0.84; CI: 0.79, 0.90) race/ethnicity. The odds of receiving >5 days of dispensed opioid prescription supply did not differ significantly among race/ethnic categories.
Our study confirms previous findings that as compared to NHW, the NHB children were less likely to receive dispensed opioid prescriptions. Also, it reveals that the different minority race/ethnic groups are not homogenous in their likelihoods of receiving dispensed opioid prescriptions after a limb fracture compared to NHW, findings underreported in previous studies. Children in the Other/Unknown race/ethnicity category have prescribing patterns different from those of other minority race/ethnic groups and should be analyzed separately.
在儿科人群中，研究不同种族/族裔群体的肢体骨折患者开出的阿片类药物处方模式。
我们使用了南卡罗来纳州 2000 年至 2018 年的医疗补助索赔数据，用于研究从急诊科出院的儿科肢体骨折病例（年龄在 19 岁以下）。主要的自变量是患儿的种族/族裔。结果为：1）患者是否有开出的阿片类药物处方；2）在有任何开出的阿片类药物处方的病例中，开出的阿片类药物供应是否超过 5 天。使用逻辑回归模型来检验种族/族裔与结果之间的关联。协变量包括服务时的年龄、性别、服务年份和多发性骨折损伤。
与非西班牙裔白人（NHW）病例相比，非西班牙裔黑人（NHB）（OR=0.73；95%置信区间[CI]：0.71，0.75）、亚洲人（OR=0.69；CI：0.53，0.90）、其他/未知（OR=0.86；CI：0.80，0.92）和西班牙裔（OR=0.84；CI：0.79，0.90）病例开出阿片类药物处方的可能性较低。在不同的种族/族裔类别中，开出超过 5 天的阿片类药物处方供应的可能性没有显著差异。
我们的研究证实了先前的发现，与 NHW 相比，NHB 患儿开出阿片类药物处方的可能性较低。此外，它表明，与 NHW 相比，不同的少数族裔群体在肢体骨折后开出阿片类药物处方的可能性并不相同，这是以前的研究中报道较少的发现。其他/未知种族/族裔类别的儿童的处方模式与其他少数族裔群体不同，应单独进行分析。
