Analgesia Disparities in Hispanic vs White Patients with Long Bone Fractures

Background Patients presenting to the emergency department (ED) with long bone fractures often require opioid or nonopioid analgesics. Historical data reveal racial disparities, with White patients more likely to receive pain medications than Hispanic patients. Study Objectives This study investigates differences in the administration of opioid and nonopioid analgesics to Hispanic and White ED patients with long bone and femur fractures over the last 20 years. Methods Opioid and nonopioid analgesic administration rates in Hispanic and White patients with femur and long bone fractures were analyzed from 2004 to 2024 at 5-year intervals using data from 112 million patients within 64 U.S. healthcare organizations. Propensity matching was performed on demographic variables. Results There were 771,945 Hispanic or White patients identified with long bone fractures and 159,196 patients with femur fractures before propensity matching, and 248,008 with long bone fractures and 26,210 with femur fractures after propensity matching. In the propensity matched dataset, there was a significant gap in opioid analgesia use for long bone (10.4% vs. 21.4%, p < 0.001) and femur fractures (16.6% vs. 40.0%, p < 0.001) between Hispanic and White patients from 2004 to 2009. This disparity persisted through 2019–2024 for long bone (42.0% vs. 49.3%, p < 0.001) and femur (66.7% vs 77.7%, p < 0.001) fractures. Trends were comparable in the nonopioid cohorts. Conclusion Over the past two decades, Hispanic patients with long bone and femur fractures were administered lower rates of opioid and nonopioid analgesia compared to White patients. This suggests that ethnic differences may still contribute significantly to disparities in analgesia administration in the ED.