title: Prospective, 10-year evaluation of the impact of Hispanic ethnicity on pain management practices in the ED.
abstract: BACKGROUND
  Hispanic ethnicity has been reported as an independent risk factor for oligoanalgesia in the emergency department (ED).
  
  
  OBJECTIVE
  The objectives are to compare pain management practices in White and Hispanic patients in the ED to determine whether treatment differences exist.
  
  
  METHODS
  Prospective analysis of a convenience sample of patients presenting to an urban, academic, tertiary-care ED over the 10-year period from 2000 to 2010. We compared patients with pain-related complaints of any nature, who self-identified their race as White or Hispanic, and evaluated initial morphine administration/dosing, arrival/disposition pain scores, and overall ED satisfaction scores (0-10 scale).
  
  
  RESULTS
  Fifteen thousand sixty patients were enrolled. Eighty-one point 2 percent (n, 12 232) of the patients were White and 11.2% (n, 1680), Hispanic. White and Hispanic patients reported similar pain at presentation (6.7 vs 7.3, P < .001) and discharge/admission (4.6 vs 4.8, P = .14). Hispanic patients were not less likely to receive an analgesic during the ED visit (odds ratio, 1.06; confidence interval, 0.96-1.17; P = .62), nor less likely to receive an opioid analgesic (odds ratio, 0.97; confidence interval, 0.88-1.08; P = .70). Hispanic patients, on average, received similar initial doses of morphine (4.1 vs 4.3 mg, P = .29) and had similar wait times from arrival to initial dose of morphine (82 vs 86 minutes). Overall ED satisfaction scores were the same (8.7 vs 8.7, P = .65).
  
  
  CONCLUSIONS
  White and Hispanic patients were similar in rates of initial morphine administration for pain-related complaints. These findings contrast with previous studies reporting lower rates of initial analgesia administration among Hispanic patients in the ED.
authors.affiliation: University of Utah School of Medicine, Salt Lake City, UT. Electronic address: philcraven14@hotmail.com.
authors.forename: Philip
authors.initials: P
authors.lastname: Craven
authors.affiliation: University of Utah School of Medicine, Salt Lake City, UT.
authors.forename: Orhan
authors.initials: O
authors.lastname: Cinar
authors.affiliation: University of Utah School of Medicine, Salt Lake City, UT.
authors.forename: David
authors.initials: D
authors.lastname: Fosnocht
authors.affiliation: University of Utah School of Medicine, Salt Lake City, UT.
authors.forename: Jessica
authors.initials: J
authors.lastname: Carey
authors.affiliation: University of Utah School of Medicine, Salt Lake City, UT.
authors.forename: Adrienne
authors.initials: A
authors.lastname: Carey
authors.affiliation: University of Utah School of Medicine, Salt Lake City, UT.
authors.forename: LeGrand
authors.initials: L
authors.lastname: Rogers
authors.affiliation: University of Utah School of Medicine, Salt Lake City, UT.
authors.forename: Kajsa
authors.initials: K
authors.lastname: Vlasic
authors.affiliation: University of Utah School of Medicine, Salt Lake City, UT.
authors.forename: Troy
authors.initials: T
authors.lastname: Madsen
mesh_terms: D000046:Academic Medical Centers; D000328:Adult; D000700:Analgesics / Q000008:administration & dosage / Q000627:therapeutic use; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000627:therapeutic use; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D054625:Healthcare Disparities / Q000706:statistics & numerical data*; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D059408:Pain Management / Q000379:methods / Q000706:statistics & numerical data*; D010147:Pain Measurement; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D011446:Prospective Studies; D014589:Utah / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data
chemical_list: D000700:Analgesics; D000701:Analgesics, Opioid