Racial differences in health care utilization among patients with osteoarthritis.
OBJECTIVE
Research has identified racial variations in certain aspects of osteoarthritis (OA) related medical care. We compared health services utilization between African American and white veteran outpatients with OA.


METHODS
Subjects were 1612 white and 861 African American patients receiving medical care for OA at the Durham VAMC, Durham, NC, USA. Two major components of OA related medical care were examined during a one-year period: physician visits and use of analgesic and antiinflammatory medications.


RESULTS
There were no racial differences in overall frequency of OA related physician visits or visits to rheumatologists. About 86% of both African American and white patients were prescribed some analgesic or antiinflammatory medication. There were, however, racial differences in the use of specific drug classes. African Americans were more likely to be prescribed nonselective nonsteroidal antiinflammatory drugs (69% vs 60%), but less likely to be prescribed COX-2 inhibitors (4% vs 7%) and narcotic analgesics (33% vs 40%) than whites (all p < 0.05). African Americans also had a shorter annual mean days' supply for several common medications, including acetaminophen, acetaminophen combined with codeine, and acetaminophen combined with oxycodone (all p < 0.05).


CONCLUSIONS
African Americans and white veterans with OA did not differ substantially in their use of physician services. However, within this equal access health care system that requires minimal co-payments for medications, there were racial differences in prescription medication use. These differences may have implications for both quality of pain relief and risk of side effects.
Dominick
Kelli L
KL
Center for Health Services Research in Primary Care, Durham VAMC (152), 508 Fulton Street, Durham, NC 27705, USA. domin004@mc.duke.edu
Dudley
Tara K
TK
Grambow
Steven C
SC
Oddone
Eugene Z
EZ
Bosworth
Hayden B
HB
D001741:Black or African American; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009657:North Carolina / Q000453:epidemiology; D010003:Osteoarthritis / Q000188:drug therapy / Q000208:ethnology*; D010045:Outpatients; D010349:Patient Compliance / Q000208:ethnology* / Q000706:statistics & numerical data; D014481:United States; D014493:United States Department of Veterans Affairs; D044465:White People
D000893:Anti-Inflammatory Agents; D000894:Anti-Inflammatory Agents, Non-Steroidal