Opioid-related US hospital discharges by type, 1993–2016

Peterson, Cora; Xu, Likang; Florence, Curtis S.; Mack, Karin A.

doi:10.1016/j.jsat.2019.05.003

Cited by 18 publications

(29 citation statements)

References 23 publications

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“… 19 , 20 This study’s results suggest that SUD creates substantial costs for hospitals and payers, yet few hospital patients receive SUD treatment services. 4 , 21 , 22 Aligning incentives such that prevention cost savings accrue to payers and practitioners that are otherwise responsible for medical costs associated with SUD in hospitals and other health care settings may encourage prevention investment.…”

Section: Discussionmentioning

confidence: 99%

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Assessment of Annual Cost of Substance Use Disorder in US Hospitals

Peterson

et al. 2021

JAMA Netw Open

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107

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IMPORTANCE A persistently high US drug overdose death toll and increasing health care use associated with substance use disorder (SUD) create urgency for comprehensive estimates of attributable direct costs, which can assist in identifying cost-effective ways to prevent SUD and help people to receive effective treatment. OBJECTIVE To estimate the annual attributable medical cost of SUD in US hospitals from the health care payer perspective. DESIGN, SETTING, AND PARTICIPANTS This economic evaluation of observational data used multivariable regression analysis and mathematical modeling of hospital encounter costs, controlling for patient demographic, clinical, and insurance characteristics, and compared encounters with and without secondary SUD diagnosis to statistically identify the total attributable cost of SUD. Nationally representative hospital emergency department (ED) and inpatient encounters from the 2017 Healthcare Cost and Utilization Project Nationwide Emergency Department Sample and National Inpatient Sample were studied. Statistical analysis was performed from March to June 2020.

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Section: Discussionmentioning

confidence: 99%

“…2 , 3 Hospital encounters with SUD as a concomitant condition (not principal diagnosis) are also increasing; admissions documenting patients’ opioid use disorder without overdose quadrupled from 1993 to 2016 (to 155 discharges per 100 000 population). 4 …”

Section: Introductionmentioning

confidence: 99%

Assessment of Annual Cost of Substance Use Disorder in US Hospitals

Peterson

et al. 2021

JAMA Netw Open

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107

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“…4 Studies have examined the prevalence of drug overdose -particularly opioid overdose -in the general U.S. adult population, 5 college students, 6 patients with chronic and non-chronic pain, [7][8][9][10][11] veterans, 12,13 and pregnant women. 14,15 Data sources have included clinical data such as hospital discharge data, 16 health insurance data, 17 national population-based surveys, 18 and vital statistics. 2 However, little is known about the prevalence of prescription opioid use among the working population.…”

mentioning

confidence: 99%

Prevalence and Expenses of Outpatient Opioid Prescriptions, With Associated Sociodemographic, Economic, and Work Characteristics

2019

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Information on opioids obtained by workers is important for both health and safety. We examined the prevalence and total expenses of obtaining outpatient opioid prescriptions, along with associated sociodemographic, economic, and work characteristics, in national samples of U.S. workers. We used Medical Expenditure Panel Survey data (2007–2016) along with descriptive and multiple logistic regression. During the study period, an estimated 21 million workers (12.6%) aged 16 years or older obtained one or more outpatient opioid prescriptions, at an expense of $2.81 billion per year. Private health insurance covered half of the total opioid expenses for workers. The prevalence of obtaining opioid prescriptions was higher for women than for men, but men had higher opioid expenses. In addition, the prevalence of obtaining opioid prescriptions was higher for workers who were older; non-Hispanic white; divorced, separated, or widowed; and non-college-educated. There is an inverse relationship between family income and the likelihood of obtaining opioids. Compared to workers with private insurance, workers with public health insurance had higher expenses for opioid prescriptions. Finally, workers in occupations at higher risk for injury and illness – including construction and extraction; farming; service; and production, transportation, and material moving occupations – were more likely to obtain opioid prescriptions.

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“…Over the past 20 years, the annual rate of hospital discharges documenting OUD has quadrupled 1 . During 2010‐2016, the annual discharge rate for heroin overdoses increased by 23% 1 .…”

Section: The Problem and The Role Of The Hospitalistmentioning

confidence: 99%

“…Over the past 20 years, the annual rate of hospital discharges documenting OUD has quadrupled 1 . During 2010‐2016, the annual discharge rate for heroin overdoses increased by 23% 1 . Although the total number of hospitalizations in the United States remained stable from 2002 to 2012, the number of admissions for opioid abuse or dependence increased from 301,707 to 520,275.…”

Section: The Problem and The Role Of The Hospitalistmentioning

confidence: 99%

Missed Opportunities for Treatment of Opioid Use Disorder in the Hospital Setting: Updating an Outdated Policy

Rogers

Wilson

Thakrar

et al. 2019

Journal of Hospital Medicine

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Opioid use disorder (OUD) is a common, underrecognized, undertreated, and deadly medical condition. Although the focus of addressing the opioid epidemic has been centered in the outpatient setting, hospitalists play an important-and often underutilized-role in identifying OUD, initiating treatment, and assisting with linkage to longitudinal care after discharge.Over the past 20 years, the annual rate of hospital discharges documenting OUD has quadrupled. 1 During 2010-2016, the annual discharge rate for heroin overdoses increased by 23%. 1 Although the total number of hospitalizations in the United States remained stable from 2002 to 2012, the number of admissions for opioid abuse or dependence increased from 301,707 to 520,275. More than 500,000 hospital admissions per year (1% of total nationwide hospitalizations) are now due primarily to OUD. 2 Injection opioid use increases the risk of endocarditis, osteomyelitis, septic arthritis, and epidural abscesses, conditions that often prolong hospitalizations and frequently lead to readmissions. Admissions for OUD-related infections are rising at a startling rate. Between 2002 and 2012, the number of admissions for infections associated with OUDs had increased from 3,421 to 6,535. 2 In addition to providing the opportunity to diagnose OUD, hospitalizations offer an ideal time to engage patients in OUD treatment and linkage to outpatient care.Although we uniformly offer patients antibiotic treatment for acute infection, hospitalists should consistently incorporate treatment of OUD to address the root cause of these admissions. As infection is but one sequelae of the underlying disease of addiction, treating without medications for OUD (MOUD) would be akin to treating a diabetic foot ulcer with antibiotics and not providing medications to improve glycemic control. Omitting such addiction treatment can contribute to treatment failure and worse health outcomes. Among patients with endocarditis and an associated valve repair, those who continue injection drug use have a 10 times higher risk of death or reoperation between 90 and 180 days after repair than those not engaged in drug use. 3 Despite data demonstrating the significant benefit and the minimal harm of MOUD, significant gaps remain in providing MOUD and linking patients from the hospital to community care. 1,4 Hospital encounters are missed opportunities to provide life-saving MOUD treatment; the majority of patients with OUD do not receive evidence-based treatment while inpatient. 5 Rosenthal et al. found that of 102 patients admitted with injection drug use-associated infective endocarditis from 2004 to 2014, only 8% received MOUD, and approximately half had a documentation of substance use treatment in their discharge worksheet. 4 In Massachusetts, among individuals who experienced a nonfatal opioid overdose and had interaction with healthcare services, only 26% were on MOUD one year later. 6 Based on our experience, a substantial proportion of patients with OUD do not seek or have access to medical care, acut...

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Opioid-related US hospital discharges by type, 1993–2016

Cited by 18 publications

References 23 publications

Assessment of Annual Cost of Substance Use Disorder in US Hospitals

Assessment of Annual Cost of Substance Use Disorder in US Hospitals

Prevalence and Expenses of Outpatient Opioid Prescriptions, With Associated Sociodemographic, Economic, and Work Characteristics

Missed Opportunities for Treatment of Opioid Use Disorder in the Hospital Setting: Updating an Outdated Policy

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