Background In the US racial minorities are at a greater risk of receiving a lower quality of medical care. While hundreds of documented studies have identified racial treatment disparities in many areas of medicine, the field of Emergency Medical Services (EMS) remains relatively unexamined.
Objectives This study explores racial treatment disparities in EMS pain management practices for adult patients who engage with pre-hospital emergency medical services for traumatic or painful emergencies.
Methods This study is a quantitative analysis of 104 210 medical charts from 63 EMS agencies in Oregon from 2015 through 2017. Primary measures include the receipt of pain medication (outcome), patient race (predictor), and numerous control variables including EMS provider impression, pain severity, and socioeconomic status (SES) covariates.
Results African American patients were 40% less likely (adjusted OR 0.60, 95% CI 0.53 to 0.68), and Asian patients were 36% less likely (adjusted OR 0.64, 95% CI 0.50 to 0.83), to receive any pain medication compared to White patients while controlling for common clinical and SES confounders. Secondary analysis indicated African Americans with private insurance experienced an even larger disparity (adjusted OR 0.45, 95% CI 0.31 to 0.64) compared to White patients with private insurance.
Conclusions African American patients and Asian patients in Oregon receiving pre-hospital emergency medical assistance for painful injuries or conditions are significantly less likely to receive the same treatment as White patients. While this finding is consistent with many studies in the Emergency Department, these results demonstrate that racial disparities exist in EMS treatment.
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