Objectives: To determine whether pediatric Native American patients with long bone fractures are as likely to receive adequate analgesia as non-Native Americans with similar fractures at a regional academic hospital in the Southwest. Patients and Methods: Charts of 61 Native Americans and 121 non-Native American patients ages 2 months to 15 years discharged from the pediatric emergency department (PED) or the pediatric urgent care (PUC) with long-bone fractures between June 2005 and May 2007 were reviewed. Insurance status, either Indian Health Service or exempt Medicaid, indicated Native American ethnicity. Potential confounders: age, language, gender, need for fracture reduction, previous analgesia, fracture location, and site of treatment were abstracted. Age, language, gender, pain score, and duration of analgesia at discharge were analyzed. Dose adequacy (mg/kg) and the likelihoods of receiving any analgesia or narcotic analgesia were calculated. Univariate analysis was performed to assess potential confounding variables on the likelihood of receiving analgesia; multivariate analysis was performed to control for variables shown to have an effect. Results: Neither demographic data nor pain scores differed significantly between the two groups. 61% of Native Americans and 65% of non-Native Americans received analgesia (p=0.53). Native Americans were as likely to receive narcotic analgesia (p=0.24) and to receive an adequate dose as non-Native Americans (p=0.24). Age, language, and gender correlated with the likelihood of receiving analgesia. Pain score did not correlate (p=0.09). Conclusions: Native American ethnicity did not affect quality of analgesia care in this multi-ethnic hospital.
Greening, Allison; Katherine Gnauck; and Betty Skipper. "The Effect of Ethnicity on Extremity Fracture Analgesia in Native American Patients at a Regional Children's Hospital." (2008). http://digitalrepository.unm.edu/ume-research-papers/7