Racial and Ethnic Disparities in Discharge Opioid Prescribing From a Hospital Medicine Service

Abstract

BACKGROUND: Differential opioid prescribing patterns have been reported in non-White patient populations. However, these disparities have not been well described among hospitalized medical inpatients. OBJECTIVE: To describe differences in opioid prescribing patterns among inpatients discharged from the general medicine service based on race/ethnicity. DESIGN, SETTING, AND PARTICIPANTS: For this retrospective study, we performed a multivariable logistic regression for patient race/ethnicity and whether patients received an opioid prescription at discharge and a negative binomial regression for days of opioids prescribed at discharge. The study included all 10,953 inpatients discharged from the general medicine service from June 2012 to November 2018 at University of California San Francisco Medical Center who received opioids during the last 24 hours of their hospitalization. MAIN OUTCOMES AND MEASURES: We examined two primary outcomes: whether a patient received an opioid prescription at discharge, and, for patients prescribed opioids, the number of days dispensed. RESULTS: Compared with White patients, Black patients were less likely to receive an opioid prescription at discharge (predicted population rate of 47.6% vs 50.7%; average marginal effect [AME], −3.1%; 95% CI, −5.5% to −0.8%). Asian patients were more likely to receive an opioid prescription on discharge (predicted population rate, 55.6% vs 50.7%; AME, +4.9; 95% CI, 1.5%-8.3%). We also found that Black patients received a shorter duration of opioid days compared with White patients (predicted days of opioids on discharge, 15.7 days vs 17.8 days; AME, −2.1 days; 95% CI, −3.3 to −0.9). CONCLUSION: Black patients were less likely to receive opioids and received shorter courses at discharge compared with White patients, adjusting for covariates. Asian patients were the most likely to receive an opioid prescription.

Georgia Quality Improvement Programs Multi-Institutional Collection of Postoperative Opioid Data Using ACS-NSQIP Abstraction

“…There have been a multitude of studies describing racial disparities in pain management. 14,15 Our study showed decreased odds of OSS use in African American patients compared to Caucasian on univariate analysis. This also shows a potential area for improvement throughout the state.…”

Race, Gender, and Primary Language Were Not Associated With Changes in Opioid Prescribing in Children: Results From a Single Institution, 2010 to 2020

“…Indeed, patient characteristics such as geographic location, race, and type of insurance have been shown to influence opioid prescribing habits [14,34]. Multiple studies have demonstrated that adults who are non-White are less likely to receive opioids for pain control than adults who are White [1,16,20,21,32]. However, there is a lack of research into the association of race and opioid prescribing in the pediatric population.…”

CORR Insights®: Are There Differences in Postoperative Opioid Prescribing Across Racial and Ethnic Groups? Assessment of an Academic Health System

“…R acial disparities in opioid prescribing patterns in United States healthcare delivery systems have been well described for many years [10]. Numerous studies have demonstrated lower rates of opioid prescriptions for Black and Hispanic patients than for their White counterparts across several healthcare contexts, including the emergency department [13,17], inpatient medicine [14], general surgery [8], and outpatient chronic pain management [15].…”