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Report Quantifies Staggering Impact of Overdose on Hospital Care

January 07, 2019
An analysis of data from nearly 650 acute-care hospitals across the country shows in stark detail the significant impact of opioid overdose on hospital services, including the effect of readmission among patients with opioid use disorders. The analysis, from Charlotte, N.C.-based healthcare improvement consultant Premier Inc., was designed to give participating hospitals a clearer picture of the ways in which opioid addiction is affecting all aspects of hospital operations. Facilities from which the data was gathered also can see how their numbers compare with those of other hospitals in their state. Comparisons within states are important given the significant regional differences seen across the country in the impacts of the opioid crisis, says Ray Perigard, Premier's director of data optimization. The analysis found that when combining the costs of emergency care and both inpatient hospitalization and intensive care unit (ICU) services following emergency care, opioid overdose generated $1.94 billion in annual hospital costs across the 647 studied facilities. This covers only the costs of care for those individuals who originally presented in an emergency department (ED), Perigard tells Behavioral Healthcare Executive. “Hospitals are really concerned about ED use,” says Roshni Ghosh, MD, MPH, Premier's vice president and chief medical information officer. “This report shows them the patients that they probably have to start tracking,” in order to improve care coordination and reduce the chances of repeat overdose and readmission. Looking at the numbers The analysis encompassed nearly 100,000 opioid overdose patients with around 430,000 total hospital visits. Among the findings: Sixty-six percent of these patients were insured by public programs, with an even distribution of Medicare and Medicaid patients. Sixteen percent had private insurance, 14% were uninsured and 3% were covered by workers' compensation or other programs. Around 47% of overdose patients seen in an ED were treated there and released, with 53% treated and admitted to the hospital. Approximately 24% of those who were released from the ED without admission were readmitted for additional emergency care within 30 days. This exceeds the typical 30-day readmission rate seen in the general Medicare population, the report states. Average per-patient costs were $504 for individuals treated and released from the ED, $11.731 for those admitted to the hospital, and $20,500 for those requiring intensive care. Fifty-eight percent of the treated individuals were treated for undetermined opioid poisoning, a category that includes prescription opioids. Thirty-four percent were treated for heroin poisoning. Perigard pointed out, however, that it is often the case that hospital staff does not know precisely what drug caused an overdose. Extrapolating the costs seen in this analysis to the entire U.S. healthcare system, Premier stated that hospital care for overdose patients adds $11.3 billion in costs annually. Ghosh tells Behavioral Healthcare Executive that the analysis should help demonstrate to hospitals that the opioid crisis is affecting more than just one silo of their operations. This should help build a sense of urgency around devising ways to improve the process of care for these patients, she says. Perigard adds that hospitals are seeking this data in order to launch conversations with state and community organizations around better engagement and care strategies for individuals with opioid use disorders.
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