A national study of racial differences in pain screening rates in the VA health care system

Diana J. Burgess, Amy A. Gravely, David B. Nelson, Michelle Van Ryn, Matthew Bair, Robert D. Kerns, Diana M. Higgins, Melissa R. Partin

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

To determine whether black patients are less likely to be screened for pain than white patients. PARTICIPANTS:: A sample of 25,382 black and 220,122 non-Hispanic white Veterans Affairs (VA) patients was identified among the panel surveyed in the ambulatory care module of the 2007 Survey of Health Care Experiences of Patients. DESIGN:: This was a cross-sectional analysis of documentation of a pain score in the electronic medical record at the patient's Survey of Health Care Experiences of Patients index visit. Hierarchical logistic regression analyses were used to examine the association between race and documentation of pain screening. RESULTS:: After accounting for site and whether the patient was a new or established primary care patient, black VA patients were significantly less likely than their white counterparts to be screened for pain, odds ratio: 0.79, P<0.0001, with estimated screening rates of 78% and 82% for black and white established primary care patients at a typical VA site, respectively. Further adjusting for demographics, medical and psychological comorbidity, prescription of pain medication, and health care utilization reduced the odds ratio to 0.86, P<0.0001). Additional analyses revealed that this reduction in odds ratio was primarily explained by higher rates of outpatient visits to the VA in the previous 2 years among black patients, which was associated with lower rates of screening at the index visit. CONCLUSIONS:: Rates of screening were lower among black patients. The magnitude of this disparity was small and was explained, in part, by racial variation in prior health care utilization.

Original languageEnglish
Pages (from-to)118-123
Number of pages6
JournalClinical Journal of Pain
Volume29
Issue number2
DOIs
StatePublished - Feb 2013

Fingerprint

Veterans Health
Delivery of Health Care
Pain
Veterans
Patient Acceptance of Health Care
Health Care Surveys
Odds Ratio
Documentation
Primary Health Care
Electronic Health Records
Ambulatory Care
Prescriptions
Comorbidity

Keywords

  • pain assessment
  • primary care
  • Racial disparities
  • Veterans

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine
  • Clinical Neurology

Cite this

Burgess, D. J., Gravely, A. A., Nelson, D. B., Van Ryn, M., Bair, M., Kerns, R. D., ... Partin, M. R. (2013). A national study of racial differences in pain screening rates in the VA health care system. Clinical Journal of Pain, 29(2), 118-123. https://doi.org/10.1097/AJP.0b013e31826a86ae

A national study of racial differences in pain screening rates in the VA health care system. / Burgess, Diana J.; Gravely, Amy A.; Nelson, David B.; Van Ryn, Michelle; Bair, Matthew; Kerns, Robert D.; Higgins, Diana M.; Partin, Melissa R.

In: Clinical Journal of Pain, Vol. 29, No. 2, 02.2013, p. 118-123.

Research output: Contribution to journalArticle

Burgess, DJ, Gravely, AA, Nelson, DB, Van Ryn, M, Bair, M, Kerns, RD, Higgins, DM & Partin, MR 2013, 'A national study of racial differences in pain screening rates in the VA health care system', Clinical Journal of Pain, vol. 29, no. 2, pp. 118-123. https://doi.org/10.1097/AJP.0b013e31826a86ae
Burgess, Diana J. ; Gravely, Amy A. ; Nelson, David B. ; Van Ryn, Michelle ; Bair, Matthew ; Kerns, Robert D. ; Higgins, Diana M. ; Partin, Melissa R. / A national study of racial differences in pain screening rates in the VA health care system. In: Clinical Journal of Pain. 2013 ; Vol. 29, No. 2. pp. 118-123.
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