Racial disparities across provider specialties in opioid prescriptions dispensed to Medicaid beneficiaries with chronic non-cancer pain
Published Date:Oct 07 2014
Source:Pain Med. 16(4):633-640.
Pubmed Central ID:PMC5012901
Funding:UL1 TR001111/TR/NCATS NIH HHS/United States
UL1TR000083/TR/NCATS NIH HHS/United States
U01 CE002160-01/CE/NCIPC CDC HHS/United States
T32 NR008856/NR/NINR NIH HHS/United States
U01 CE002160/CE/NCIPC CDC HHS/United States
UL1 TR000083/TR/NCATS NIH HHS/United States
T32 HS000032/HS/AHRQ HHS/United States
5 T32 HS000032/HS/AHRQ HHS/United States
K12 HD001441/HD/NICHD NIH HHS/United States
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.
A retrospective cohort study.
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.
The population included White and Black North Carolina Medicaid beneficiaries with CNCP (n=75,458).
We used bivariate statistics and logistic regression analysis to examine race-based discrepancies in opioid prescribing by physician specialty.
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)].
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.
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