A new study has demonstrated that race and economic status influence health care choices, by revealing that African Americans and low-income patients are less likely to consent to post-surgery epidural pain relief, than their white or more well off counterparts.
The research from physicians at the University of Pennsylvania School of Medicine studied how race, economic and educational status may affect health care choices when access to care isn't a factor.
Overall analysis showed that education and income were not as important as race in determining epidural acceptance, but the researchers say the costs of improper pain treatment after surgery are large for any patient group.
"Epidurals are more effective for relieving postoperative pain, and higher levels of pain have been linked to the development of chronic pain," says E. Andrew Ochroch, MD, an associate professor and director of clinical research in the Department of Anesthesiology and Critical Care.
"Consequently, if African Americans are either denied or denying themselves epidural for pain relief, then they may be at greater risk for postoperative complications," he added.
For the study, prospective surgery patients were screened using a short, scripted interview developed by a panel of anesthesiologists, neurologists and chronic pain specialists, to assess what they already knew about epidurals and what experiences, if any, they'd had with the technique before.
Physicians collected data from 1,193 patients between late August 2004 and early January 2005.
64 percent of all patients said they would accept an epidural if it was recommended by an anesthesiologist, while 36 percent said they would refuse. When asked if an additional recommendation from the surgeon would make them consent, acceptance rose to 78 percent.
But when examining differences based on race, African American patients were less likely to say they would accept an epidural under any circumstances.
Socio-economic status also appeared to influence consent. Participants who worked full- or part-time were more likely to accept an epidural compared to those who were unemployed.
Even at higher income levels, white patients were more likely than black patients to accept an epidural.
The study is published in the journal Anesthesia and Analgesia.