Pediatric opioid-related poisoning and deaths have increased by 268% between 1999 and 2016. One risk factor for these poisonings may be receiving an opioid prescription at a young age. Given the established link between legitimate opioid prescriptions and later misuse in young adulthood, research focused on identifying relationships between sociodemographic factors with opioid and non-opioid prescribing is needed to understand opioid prescribing inconsistencies and promote safe pain management. Of interest, this study examined the association between race/ethnicity and health insurance payer type with pediatric opioid and non-opioid ordering in an inpatient hospital setting. Statistical analyses were performed with cross-sectional inpatient encounter data from June 2013 to June 2018 retrieved from a pediatric hospital (N = 55,944). Physicians ordered significantly fewer opioid medications, but a greater number of non-opioid medications, for non-Hispanic African American children than non-Hispanic Asian, Hispanic/Latinx, and non-Hispanic White pediatric patients. Moreover, patients with government-sponsored plans (e.g., Medi-Cal/Medicare) received fewer non-opioid prescriptions compared with patients with both HMO and PPO coverage. There was also a significant race/ethnicity by insurance interaction on opioid orders. Non-Hispanic White patients with "other" insurance coverage received the greatest number of opioid orders. In non-Hispanic African American patients, children with PPO coverage received fewer opioids than those with government-sponsored and HMO insurance. For non-Hispanic Asian patients, children with PPO were prescribed more opioids than those with government-sponsored and HMO coverage. Overall, these findings suggest that the relationship between race/ethnicity, insurance type, and physician decisions in opioid prescribing is complex and multifaceted. Given that consistency in opioid prescribing should be seen regardless of patient background characteristics, future studies should continue to assess and monitor unequitable differences in care.
Luong, V., Ehwerhemuepha, L., Donaldson, C. D., Kain, Z., N., Fortier, M. A., Feaster, W., Weiss, M., Tomaszewski, D. M., Yang, S., Phan, M. T., & Jenkins, B. N. (2021, May). Race, ethnicity, and insurance: The association with opioid use in a pediatric hospital setting. Oral presentation at the Spring 2021 Chapman University Student Scholar Symposium.