Racial disparities across provider specialties in opioid prescriptions dispensed to Medicaid beneficiaries with chronic non-cancer pain

Details

• Alternative Title:
  Pain Med
• Personal Author:
  Ringwalt, Chris ; Roberts, Andrew W. ; Gugelmann, Hallam ; Skinner, Asheley Cockrell
• Description:
  Objective
  
  Chronic pain affects both psychological and physical functioning, and is responsible for more than $60 billion in lost productivity annually in the United States. Although previous studies have demonstrated racial disparities in opioid treatment, there is little evidence regarding disparities in treatment of chronic non-cancer pain (CNCP) and the role of physician specialty.
  
  Design
  
  A retrospective cohort study.
  
  Setting
  
  We analyzed North Carolina Medicaid claims data, from July 1, 2009 to May 31, 2010, to examine disparities by different provider specialties in beneficiaries dispensed prescriptions for opioids.
  
  Subjects
  
  The population included White and Black North Carolina Medicaid beneficiaries with CNCP (n=75,458).
  
  Methods
  
  We used bivariate statistics and logistic regression analysis to examine race-based discrepancies in opioid prescribing by physician specialty.
  
  Results
  
  Compared to White beneficiaries with CNCP (n=49,197), Black beneficiaries (n=26,261) were less likely [OR 0.91 (CI: 0.88–0.94)] to fill an opioid prescription. Our hypothesis was partially supported: we found that race-based differences in beneficiaries dispensed opioid prescriptions were more prominent in certain specialties. In particular, these differences were most salient among patients of specialists in obstetrics and gynecology [OR 0.78 (CI: 0.67–0.89)] and internal medicine [OR 0.86 (CI: 0.79–0.92)], as well as general practitioners/family medicine physicians [OR 0.91 (CI: 0.85–0.97)].
  
  Conclusions
  
  Our findings suggest that, in our study population, Black beneficiaries with CNCP are less likely than Whites to fill prescriptions for opioid analgesics as a function of their provider’s specialty. Although race-based differences in patients filling opioid prescriptions have been noted in previous studies, this is the first study that clearly demonstrates these disparities by provider specialty.
  
  
• Subjects:
  Adolescent Adult Analgesics, Opioid Black Or African American Chronic Pain Cohort Studies Delivery Of Health Care Female Humans Male Medicaid Middle Aged Pain Management Practice Patterns, Physicians' Retrospective Studies United States White People Young Adult

  More +
• Source:
  Pain Med. 16(4):633-640
• Pubmed ID:
  25287703
• Pubmed Central ID:
  PMC5012901
• Document Type:
  Journal Article
• Funding:
  UL1 TR001111/TR/NCATS NIH HHSUnited States/ ; UL1TR000083/TR/NCATS NIH HHSUnited States/ ; U01 CE002160-01/CE/NCIPC CDC HHSUnited States/ ; T32 NR008856/NR/NINR NIH HHSUnited States/ ; UL1 TR002489/TR/NCATS NIH HHSUnited States/ ; U01 CE002160/CE/NCIPC CDC HHSUnited States/ ; UL1 TR000083/TR/NCATS NIH HHSUnited States/ ; T32 HS000032/HS/AHRQ HHSUnited States/ ; 5 T32 HS000032/HS/AHRQ HHSUnited States/ ; K12 HD001441/HD/NICHD NIH HHSUnited States/
• Volume:
  16
• Issue:
  4
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:687b28685bbcc038b2c6e6b861e9a6a2b19869e5d55d6f4b7255c1fecd754bc5
• Download URL:
  https://stacks.cdc.gov/view/cdc/41202/cdc_41202_DS1.pdf
• File Type:
  [PDF - 90.87 KB ]