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Racial/Ethnic Patterns in Opioid Dispensing among Medicaid-Funded Young Children
Laksika B Sivaraj1,2, Khoa Truong1, William T Basco3
1Department of Public Health Sciences, Clemson University, Clemson, SC 29634, USA.
Insights
Racial disparities exist in pediatric opioid prescriptions for respiratory and injury conditions. White children received more respiratory opioid prescriptions, while Hispanic children received more injury opioid prescriptions, with differences widening over time.
Area of Science:
- Pediatric pharmacology
- Health disparities research
- Public health policy
Background:
- Opioid prescribing patterns in children require examination, particularly concerning racial and ethnic variations.
- Understanding these disparities is crucial for equitable healthcare delivery.
Purpose of the Study:
- To investigate racial/ethnic differences in outpatient opioid dispensing for respiratory system (RESP) and injury (INJURY) diagnoses among children aged 3 years or younger.
- To analyze trends in these dispensing rates over three distinct three-year periods.
Main Methods:
- Analysis of South Carolina Medicaid outpatient claims data for children aged 3 years or younger.
- Calculation of triennial rates of dispensed opioid prescriptions per 1000 visits for RESP and INJURY diagnoses, stratified by racial/ethnic groups.
Main Results:
- Opioid dispensing rates for RESP conditions decreased across all racial/ethnic groups. White children consistently had higher rates than Black and Hispanic children.
- Opioid dispensing rates for INJURY conditions also declined overall. Hispanic children showed the highest dispensing rates, followed by White children. The disparity in INJURY prescribing widened over time, with Hispanic children increasingly receiving more prescriptions compared to White and Black children.
Conclusions:
- Significant racial/ethnic disparities persist in pediatric opioid prescribing for both respiratory and injury-related outpatient visits.
- These differences, particularly for injury indications, have widened over the study period, highlighting a critical area for intervention to ensure equitable care.
Abstract:
Racial differences in opioid dispensing for diseases of the respiratory system (RESP) and injury (INJURY) outpatient visits among patients ≤ 3 years old were examined. Outpatient claims data of South Carolina Medicaid children were analyzed over three three-year periods. The variable of interest was the triennial rate of dispensed opioid prescriptions per 1000 visits for RESP and INJURY diagnoses across racial/ethnic groups. Overall, dispensed opioid prescription rates related to RESP declined for all racial/ethnic categories. White children had the highest dispensing rate for RESP indications in the first period (5.6), followed by Black (4.5), and Hispanic (4.1). The likelihood of White children being prescribed opioids was higher than Blacks, and this was persistent over the studied time (rate ratios from 1.24 to 1.22, respectively). Overall opioid dispensing rates related to injury declined during the studied time. Hispanics had the highest dispensing rate for INJURY (20.1 to 14.8 to 16.1, respectively) followed by White (16.1 to 13.1 to 10.4, respectively). Relative differences in the dispensing rates across groups increased over time (Hispanics vs. White: rate ratios from 1.25 to 1.55, Hispanics vs. Black: from 1.52 to 2.24, and White vs. Black: from 1.24 to 1.44, respectively). There are considerable differences in the dispensing rates across racial/ethnic groups, especially in injury-related prescribing.
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