A National Assessment of Racial Disparities in Prehospital Pain Management by Paramedics
Fales, Thomas "Jake"
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The United States has a pervasive history of racism ingrained into the fabrics of many American institutions, including healthcare. The goal of this project is to utilize statistical methods to examine nationwide racial trends in Emergency Medical Services (EMS) as they relate to predicting whether a person is given pain medication. This project first explores the history of medical racism, then discusses the elements that make EMS a unique and challenging field to research. The bulk of this project uses the National Emergency Services Information System (NEMSIS) data for 2020 (N = 43,488,767) that is filtered by many different variables, creating an analytic sample consisting of only EMS responses to 911 calls by ground transport ALS Paramedic teams, and focusing on patients who report a pain score greater than 5 out of 10. Using that sample (N = 2,063,679), I used logistic regression models to find if race changes a patient’s likelihood to receive any pain medication or to receive opiates. This process was repeated for each US Census Division to search for any potential disparities. This research found little to no meaningful statistically significant results on a nationwide scale, but did expose many fundamental limitations with the NEMSIS dataset, including unexplainable skewness and a substantial portion of missing data.