Document Type
Article
Publication Date
9-30-2020
Abstract
Background
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.
Methods
Cross-sectional inpatient encounter data from June 2013 to June 2018 was retrieved from a pediatric children’s hospital in Southern California (N = 55,944), and statistical analyses were performed to determine associations with opioid ordering.
Results
There was a significant main effect of race/ethnicity on opioid and non-opioid orders. 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. There was also a main effect of health insurance payer type on non-opioid orders. Patients with government-sponsored plans (e.g., Medi-Cal, Medicare) received fewer non-opioid prescriptions compared with patients with both HMO and PPO coverage. Additionally, there was 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.
Conclusion
Findings suggest that the relationship between race/ethnicity, insurance type, and physician decisions 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.
Recommended Citation
Ehwerhemuepha, L., Donaldson, C.D., Kain, Z.N. et al. Race, Ethnicity, and Insurance: the Association with Opioid Use in a Pediatric Hospital Setting. J. Racial and Ethnic Health Disparities 8, 1232–1241 (2021). https://doi.org/10.1007/s40615-020-00882-9
Copyright
Springer
Included in
Health and Medical Administration Commons, Health Services Administration Commons, Health Services Research Commons, Medicine and Health Commons, Other Psychiatry and Psychology Commons, Pain Management Commons, Pediatrics Commons, Race and Ethnicity Commons
Comments
This is a pre-copy-editing, author-produced PDF of an article accepted for publication in Journal of Racial and Ethnic Health Disparities, volume 8, in 2021 following peer review. The final publication may differ and is available at Springer via https://doi.org/10.1007/s40615-020-00882-9
A free-to-read copy of the final published article is available here.