Healthy Skepticism Library item: 10245

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Publication type: Journal Article

Dominick KL, Dudley TK, Grambow SC, Oddone EZ, Bosworth HB.
Racial differences in health care utilization among patients with osteoarthritis.
J Rheumatol 2003 Oct; 30:(10):2201-6

Abstract:

OBJECTIVE: Research has identified racial variations in certain aspects of osteoarthritis (OA) related medical care. We compared health services utilization between African American and white veteran outpatients with OA. METHODS: Subjects were 1612 white and 861 African American patients receiving medical care for OA at the Durham VAMC, Durham, NC, USA. Two major components of OA related medical care were examined during a one-year period: physician visits and use of analgesic and antiinflammatory medications. RESULTS: There were no racial differences in overall frequency of OA related physician visits or visits to rheumatologists. About 86% of both African American and white patients were prescribed some analgesic or antiinflammatory medication. There were, however, racial differences in the use of specific drug classes. African Americans were more likely to be prescribed nonselective nonsteroidal antiinflammatory drugs (69% vs 60%), but less likely to be prescribed COX-2 inhibitors (4% vs 7%) and narcotic analgesics (33% vs 40%) than whites (all p < 0.05). African Americans also had a shorter annual mean days’ supply for several common medications, including acetaminophen, acetaminophen combined with codeine, and acetaminophen combined with oxycodone (all p < 0.05). CONCLUSION: African Americans and white veterans with OA did not differ substantially in their use of physician services. However, within this equal access health care system that requires minimal co-payments for medications, there were racial differences in prescription medication use. These differences may have implications for both quality of pain relief and risk of side effects.

Keywords:
African Americans* Anti-Inflammatory Agents/therapeutic use Anti-Inflammatory Agents, Non-Steroidal/therapeutic use European Continental Ancestry Group* Female Humans Logistic Models Male Middle Aged North Carolina/epidemiology Osteoarthritis/drug therapy Osteoarthritis/ethnology* Outpatients* Patient Compliance/ethnology* Patient Compliance/statistics & numerical data United States United States Department of Veterans Affairs