Disparities in United States hospitalizations for serious infections in patients with and without opioid use disorder: A nationwide observational study

Abstract

Background Patients with opioid use disorder (OUD) who are hospitalized for serious infections requiring prolonged intravenous antibiotics may face barriers to discharge, which could prolong hospital length of stay (LOS) and increase financial burden. We investigated differences in LOS, discharge disposition, and charges between hospitalizations for serious infections in patients with and without OUD. Methods and findings We utilized the 2016 National Inpatient Sample-a nationally representative database of all discharges from US acute care hospitals. The population of interest was all hospitalizations for infective endocarditis, epidural abscess, septic arthritis, or osteomyelitis. The exposure was OUD, and the primary outcome was LOS until discharge, assessed by using a competing risks analysis to estimate adjusted hazard ratios (aHRs). Adjusted odds ratio (aOR) of discharge disposition and adjusted differences in hospital charges were also reported. Of 95,470 estimated hospitalizations for serious infections (infective endocarditis, epidural abscess, septic arthritis, and osteomyelitis), the mean age was 49 years and 35% were

Opioid Use Disorder Treatment Initiation and Continuation: a Qualitative Study of Patients Who Received Addiction Consultation and Hospital-Based Providers

“…Future work should evaluate if such programs reduce growing costs associated with opioid-related hospitalizations and help patients achieve their personal goals related to opioid use, including incorporating harm reduction strategies into their opioid use, initiating OAT when indicated, and/or engaging patients in behavioral health treatment. 66 …”

Musculoskeletal Disorders, Pain Medication, and in-Hospital Mortality among Patients with COVID-19 in South Korea: A Population-Based Cohort Study

“…A recent study reported that opioid use was closely related to the growing trend of infectious diseases in the United States, and opioid use created a converging public health crisis with a significant combined impact on morbidity and mortality with regard to infection [ 24 ]. Additionally, a recent nationwide cohort study in the United States on hospitalized patients with serious infection showed that underlying opioid use disorder was linked to poorer hospital outcomes [ 25 ]. Another prospective cohort study reported the association between higher all-cause mortality and long-term opioid prescription among both human immunodeficiency virus-infected and uninfected individuals [ 26 ].…”

The Dynamics of Infectious Diseases Associated With Injection Drug Use in Lawrence and Lowell, Massachusetts

“…The first lag, in which echocardiograms 8 months prior is consistent with the lagged association with current-month HIV counts seen with infective endocarditis 10 months prior. In fact, if patients from Lawrence and Lowell were referred to facilities that could offer the specialty care needed for these complex infections, which can involve prolonged courses of antibiotics and valve replacement surgery, these additional diagnostic procedures could be expected in our analysis [ 36 ]. In fact, at least one of the major hospitals caring for patients with infective endocarditis in the region conducts 30 000 echocardiograms a year, and many are for this condition [ 37 ].…”