Racial differences found in care of children with abdominal pain

Black children are less likely than white children to receive medication for abdominal pain in the emergency department (ED) even when they report severe pain, according to a study to be presented Saturday, April 28, at the Pediatric Academic Societies (PAS) annual meeting in Boston. "The emergency department serves as our nation's health care safety net, where all children can receive care regardless of their insurance status, ability to pay or race," said lead author Tiffani J. Johnson, MD, pediatric emergency medicine fellow at Children's Hospital of Pittsburgh and a postdoctoral scholar at RAND-University of Pittsburgh. "It is concerning to find that black children are less likely than white children to receive pain medication for treatment of their abdominal pain." Dr. Johnson and her colleagues analyzed data from the National Hospital Ambulatory Medical Care Survey (NHAMCS) for patients who went to the ED for abdominal pain from 2006-2009. The NHAMCS is conducted by the Centers for Disease Control and Prevention National Center for Health Statistics. In addition to the administration of pain medication, researchers looked at the use of diagnostic tests, length of stay, how often patients returned to the ED after 72 hours, and admission rates for 2,298 patients younger than age 21, representing 8.1 million patients. They compared these outcomes in white (53 percent of patients), black (23 percent) and Hispanic (21 percent) children. Results showed that black and Hispanic children were more likely to stay in the ED for more than six hours compared to white children. However, there were no racial differences in what tests were performed to evaluate the cause of abdominal pain or hospital admission rates. "All children deserve equal access to high-quality health care," said Dr. Johnson. "Identifying racial differences in the care of children is an important first step in improving the quality and equity of care that children receive in the emergency department. We need to do more research to help understand why these differences exist."