• Rachel Nelson, Julie Kittel-Moseley, Iman Mahoui, David Thornberry, Andrew Dunkman, Malik Sams, David Adler, and JonesCourtney Marie CoraCMCDepartment of Emergency Medicine, University of Rochester, School of Medicine and Dentistry, Rochester, NY 14642, United States of America; Department of Public Health Sciences, University of Rochester, School of Medicine and De.
• Department of Emergency Medicine, University of Rochester, School of Medicine and Dentistry, Rochester, NY 14642, United States of America.
• Am J Emerg Med. 2022 Oct 1; 60: 454945-49.

BackgroundPrior research has demonstrated the widespread presence of racial disparities in emergency department (ED) care and analgesia. We hypothesized that racial disparities continue to exist in ED analgesic prescribing patterns, time to analgesia, and time to provider in the treatment of headache.MethodsWe performed a retrospective cohort study of patients presenting to a large tertiary academic ED with chief complaint of headache. A structured medical record review was conducted to abstract relevant variables of interest. Patient race was categorized as white or Black, Indigenous, or person of color (BIPOC). Descriptive statistics were used to characterize the cohort and stratified analyses were conducted based on patient race and our key outcome measures of analgesic prescribing patterns, time to analgesia, and time to provider in the treatment of headache.ResultsWhite patients were more likely to be assigned an Emergency Severity Index score 2 or 3 and their BIPOC counterparts were more likely to be assigned an ESI score 3 or 4 (p = 0.02). There was no significant difference by race in time to analgesia (p = 0.318), time to provider (p = 0.358), or time to first medication treatment (p = 0.357). However, there were clear differences in prescribing patterns. BIPOC patients were significantly more likely to be treated with acetaminophen (p = 0.042) or ibuprofen (p = 0.015) despite reporting higher pain levels during triage (p < 0.001). White patients were significantly more likely to receive a head CT scan (p < 0.001) or neurology consult (p = 0.003) than their BIPOC counterparts.ConclusionRacial disparities persist in assessment and type of analgesia for patients being treated for headache in a large academic emergency department.Copyright © 2022. Published by Elsevier Inc.

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