BACKGROUND: Differential opioid prescribing patterns have been reported in non-White patient populations. However, these disparities have not been well described among hospitalized medical inpatients.

OBJECTIVE: To describe differences in opioid prescribing patterns among inpatients discharged from the general medicine service based on race/ethnicity.

DESIGN, SETTING, AND PARTICIPANTS: For this retrospective study, we performed a multivariable logistic regression for patient race/ethnicity and whether patients received an opioid prescription at discharge and a negative binomial regression for days of opioids prescribed at discharge. The study included all 10,953 inpatients discharged from the general medicine service from June 2012 to November 2018 at University of California San Francisco Medical Center who received opioids during the last 24 hours of their hospitalization.

MAIN OUTCOMES AND MEASURES: We examined two primary outcomes: whether a patient received an opioid prescription at discharge, and, for patients prescribed opioids, the number of days dispensed.

RESULTS: Compared with White patients, Black patients were less likely to receive an opioid prescription at discharge (predicted population rate of 47.6% vs 50.7%; average marginal effect [AME], −3.1%; 95% CI, −5.5% to −0.8%). Asian patients were more likely to receive an opioid prescription on discharge (predicted population rate, 55.6% vs 50.7%; AME, +4.9; 95% CI, 1.5%-8.3%). We also found that Black patients received a shorter duration of opioid days compared with White patients (predicted days of opioids on discharge, 15.7 days vs 17.8 days; AME, −2.1 days; 95% CI, −3.3 to −0.9).

CONCLUSION: Black patients were less likely to receive opioids and received shorter courses at discharge compared with White patients, adjusting for covariates. Asian patients were the most likely to receive an opioid prescription.

背景：已在非白人患者人群中报告了不同的阿片类药物处方模式。然而，这些差异在住院的内科住院患者中并没有得到很好的描述。

目的：描述基于种族/民族的从普通内科服务出院的住院患者中阿片类药物处方模式的差异。

设计、设置和参与者：对于这项回顾性研究，我们对患者种族/民族以及患者在出院时是否接受了阿片类药物处方以及出院时处方阿片类药物天数的负二项式回归进行了多变量逻辑回归。该研究包括 2012 年 6 月至 2018 年 11 月在加州大学旧金山医学中心从普通内科服务出院的所有 10,953 名住院患者，他们在住院的最后 24 小时内接受了阿片类药物治疗。

主要结果和措施：我们检查了两个主要结果：患者是否在出院时收到了阿片类药物处方，以及对于处方阿片类药物的患者，配药天数。

结果：与白人患者相比，黑人患者在出院时接受阿片类药物处方的可能性较小（预计人口率为 47.6% 对 50.7%；平均边际效应 [AME]，-3.1%；95% CI，-5.5% 至 - 0.8%）。亚洲患者更有可能在出院时接受阿片类药物处方（预计人口比率，55.6% vs 50.7%；AME，+4.9；95% CI，1.5%-8.3%）。我们还发现，与白人患者相比，黑人患者的阿片类药物天数较短（预计出院时的阿片类药物天数为 15.7 天 vs 17.8 天；AME，-2.1 天；95% CI，-3.3 至 -0.9）。

结论：在调整协变量后，与白人患者相比，黑人患者接受阿片类药物的可能性较小，并且出院时接受的疗程较短。亚洲患者最有可能接受阿片类药物处方。