Evaluation of racial disparities in postoperative opioid prescription filling after common pediatric surgical procedures
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In brief
In brief
Retrospective study of 39,316 Medicaid pediatric patients examined racial differences in postoperative opioid prescription filling after tonsillectomy, fracture repair, and appendectomy. While unadjusted data showed lower prescription rates among black appendectomy patients, no significant racial disparities persisted after controlling for clinical factors like length of stay.
Written by the GCMD Library team from the article.
Abstract
Background
Racially disparate pain management affects both adult and pediatric patients, but is not well studied among pediatric surgical patients after discharge. The objectives were to evaluate racial disparities in pediatric postoperative opioid prescription filling.
Methods
This retrospective cohort study included black or white pediatric Medicaid patients who underwent tonsillectomy, supracondylar humeral fracture fixation, or appendectomy (2/2012–7/2016). Patients were followed for 14 days post-surgery to identify opioid prescription fills. Logistic regression models evaluated the association between race and the probability of filling an opioid prescription.
Results
Among 39,316 surgical patients, the proportions of patients with post-surgical opioid prescriptions were 66.0%, 83.9%, and 68.5%, among tonsillectomy, supracondylar fracture, and appendectomy patients, respectively. The proportion of black appendectomy patients with a postoperative opioid prescription was significantly lower compared to white patients (65.0% vs. 69.2% respectively, p=0.03), but was no longer significant after adjusting for other patient and provider characteristics. There were no differences by race in opioid prescription filling among other surgical patient groups.
Conclusions
The present study did not identify racial disparities in opioid prescription filling in adjusted analyses. Racial differences in unadjusted postoperative opioid prescription filling among appendectomy patients may be explained in part by longer postoperative length-of-stay among black children.
Type of Study
Prognosis Study
Level of Evidence
Level II