The gender pain gap in prehospital analgesia: the role of patient and provider gender - an analysis of…

ObservationalBMC medicine· Aug 2026

The gender pain gap in prehospital analgesia: the role of patient and provider gender - an analysis of 106,888 helicopter emergency medical service (HEMS) missions.

Andrea Schmidt, Hans-Jörg Busch, Lilith Huebsch … Julian Ganter

Prehospital & RetrievalObservationalClinical practiceQ1IF 8.5

Women received opioid analgesia less often than men despite similar pain severity

The gender pain gap in prehospital analgesia: the role of patient and provider gender - an analysis of 106,888 helicopter emergency medical service (HEMS) missions.

Andrea Schmidt … Julian Ganter

BMC medicine · Aug 2026 · Q1 in General Medicine

Background

Pain management is a core ethical principle in emergency medicine, yet gender-related differences in analgesic treatment have been reported.

Purpose

This study examines whether patient and emergency physician gender influence prehospital pain management.

Methods

This retrospective observational cohort study included all primary helicopter emergency medical service missions conducted by DRF Stiftung Luftrettung in Germany between January 2012 and June 2025.

n = 106,888 cases

Results

50.0%

vs. 57.1%

opioids given less often to women, though pain levels were the same

n = 106,888 cases

More results

Initial pain severity was comparable between genders, with a similar distribution across Numeric Rating Scale categories.

This finding is consistent across all pain severity subgroups.

Pain scores at patient handover were similar for women and men, indicating comparable pain levels at the end of prehospital care.

“

Conclusion · 1 of 2

Despite comparable pain intensity, women received analgesic and opioid treatment less frequently than men in prehospital care, indicating potential gender-based inequalities in pain management.

Conclusion · 2 of 2

These findings underscore the need for strategies to ensure equitable analgesic treatment.

The gender pain gap in prehospital analgesia: the role of patient and provider gender - an analysis of 106,888 helicopter emergency medical service (HEMS) missions.

The gender pain gap in prehospital analgesia: the role of patient and provider gender - an analysis of 106,888 helicopter emergency medical service (HEMS) missions.

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