Healthcare costs and use before and after opioid overdose in Veterans Health Administration patients with opioid use disorder
© 2023 The Authors. Addiction published by Society for the Study of Addiction on behalf of Society for the Study of Addiction. This article has been contributed to by U.S. Government employees and their work is in the public domain in the USA..
AIMS: To compare healthcare costs and use between United States (US) Veterans Health Administration (VHA) patients with opioid use disorder (OUD) who experienced an opioid overdose (OD cohort) and patients with OUD who did not experience an opioid overdose (non-OD cohort).
DESIGN: This is a retrospective cohort study of administrative and clinical data.
SETTING: The largest integrated national health-care system is the US Veterans Health Administration's healthcare systems.
PARTICIPANTS: We included VHA patients diagnosed with OUD from October 1, 2017 through September 30, 2018. We identified the index date of overdose for patients who had an overdose. Our control group, which included patients with OUD who did not have an overdose, was randomly assigned an index date. A total of 66 513 patients with OUD were included for analysis (OD cohort: n = 1413; non-OD cohort: n = 65 100).
MEASUREMENTS: Monthly adjusted healthcare-related costs and use in the year before and after the index date. We used generalized estimating equation models to compare patients with an opioid overdose and controls in a difference-in-differences framework.
FINDINGS: Compared with the non-OD cohort, an opioid overdose was associated with an increase of $16 890 [95% confidence interval (CI) = $15 611-18 169; P < 0.001] in healthcare costs for an estimated $23.9 million in direct costs to VHA (95% CI = $22.1 million, $25.7 million) within the 30 days following overdose after adjusting for baseline characteristics. Inpatient costs ($13 515; 95% CI = $12 378-14 652; P < 0.001) reflected most of this increase. Inpatient days (+6.15 days; 95% CI, = 5.33-6.97; P < 0.001), inpatient admissions (+1.01 admissions; 95% CI = 0.93-1.10; P < 0.001) and outpatient visits (+1.59 visits; 95% CI = 1.34-1.84; P < 0.001) also increased in the month after opioid overdose. Within the overdose cohort, healthcare costs and use remained higher in the year after overdose compared with pre-overdose trends.
CONCLUSIONS: The US Veterans Health Administration patients with opioid use disorder (OUD) who have experienced an opioid overdose have increased healthcare costs and use that remain significantly higher in the month and continuing through the year after overdose than OUD patients who have not experienced an overdose.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2023 |
|---|---|
| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:118 |
|---|---|
| Enthalten in: |
Addiction (Abingdon, England) - 118(2023), 11 vom: 03. Nov., Seite 2203-2214 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Joyce, Vilija R [VerfasserIn] |
|---|
| Links: |
|---|
| Anmerkungen: |
Date Completed 23.10.2023 Date Revised 10.11.2023 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1111/add.16289 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM359664431 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM359664431 | ||
| 003 | DE-627 | ||
| 005 | 20231226081346.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231226s2023 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1111/add.16289 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1198.xml |
| 035 | |a (DE-627)NLM359664431 | ||
| 035 | |a (NLM)37465971 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Joyce, Vilija R |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Healthcare costs and use before and after opioid overdose in Veterans Health Administration patients with opioid use disorder |
| 264 | 1 | |c 2023 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 23.10.2023 | ||
| 500 | |a Date Revised 10.11.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2023 The Authors. Addiction published by Society for the Study of Addiction on behalf of Society for the Study of Addiction. This article has been contributed to by U.S. Government employees and their work is in the public domain in the USA. | ||
| 520 | |a AIMS: To compare healthcare costs and use between United States (US) Veterans Health Administration (VHA) patients with opioid use disorder (OUD) who experienced an opioid overdose (OD cohort) and patients with OUD who did not experience an opioid overdose (non-OD cohort) | ||
| 520 | |a DESIGN: This is a retrospective cohort study of administrative and clinical data | ||
| 520 | |a SETTING: The largest integrated national health-care system is the US Veterans Health Administration's healthcare systems | ||
| 520 | |a PARTICIPANTS: We included VHA patients diagnosed with OUD from October 1, 2017 through September 30, 2018. We identified the index date of overdose for patients who had an overdose. Our control group, which included patients with OUD who did not have an overdose, was randomly assigned an index date. A total of 66 513 patients with OUD were included for analysis (OD cohort: n = 1413; non-OD cohort: n = 65 100) | ||
| 520 | |a MEASUREMENTS: Monthly adjusted healthcare-related costs and use in the year before and after the index date. We used generalized estimating equation models to compare patients with an opioid overdose and controls in a difference-in-differences framework | ||
| 520 | |a FINDINGS: Compared with the non-OD cohort, an opioid overdose was associated with an increase of $16 890 [95% confidence interval (CI) = $15 611-18 169; P < 0.001] in healthcare costs for an estimated $23.9 million in direct costs to VHA (95% CI = $22.1 million, $25.7 million) within the 30 days following overdose after adjusting for baseline characteristics. Inpatient costs ($13 515; 95% CI = $12 378-14 652; P < 0.001) reflected most of this increase. Inpatient days (+6.15 days; 95% CI, = 5.33-6.97; P < 0.001), inpatient admissions (+1.01 admissions; 95% CI = 0.93-1.10; P < 0.001) and outpatient visits (+1.59 visits; 95% CI = 1.34-1.84; P < 0.001) also increased in the month after opioid overdose. Within the overdose cohort, healthcare costs and use remained higher in the year after overdose compared with pre-overdose trends | ||
| 520 | |a CONCLUSIONS: The US Veterans Health Administration patients with opioid use disorder (OUD) who have experienced an opioid overdose have increased healthcare costs and use that remain significantly higher in the month and continuing through the year after overdose than OUD patients who have not experienced an overdose | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, U.S. Gov't, Non-P.H.S. | |
| 650 | 4 | |a Research Support, N.I.H., Extramural | |
| 650 | 4 | |a Economics | |
| 650 | 4 | |a Unites States | |
| 650 | 4 | |a healthcare costs | |
| 650 | 4 | |a opiate overdose | |
| 650 | 4 | |a opioid-related disorders | |
| 650 | 4 | |a utilization | |
| 650 | 4 | |a veterans | |
| 650 | 7 | |a Analgesics, Opioid |2 NLM | |
| 700 | 1 | |a Oliva, Elizabeth M |e verfasserin |4 aut | |
| 700 | 1 | |a Garcia, Carla C |e verfasserin |4 aut | |
| 700 | 1 | |a Trafton, Jodie |e verfasserin |4 aut | |
| 700 | 1 | |a Asch, Steven M |e verfasserin |4 aut | |
| 700 | 1 | |a Wagner, Todd H |e verfasserin |4 aut | |
| 700 | 1 | |a Humphreys, Keith |e verfasserin |4 aut | |
| 700 | 1 | |a Owens, Douglas K |e verfasserin |4 aut | |
| 700 | 1 | |a Bounthavong, Mark |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Addiction (Abingdon, England) |d 1993 |g 118(2023), 11 vom: 03. Nov., Seite 2203-2214 |w (DE-627)NLM075102978 |x 1360-0443 |7 nnns |
| 773 | 1 | 8 | |g volume:118 |g year:2023 |g number:11 |g day:03 |g month:11 |g pages:2203-2214 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1111/add.16289 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 118 |j 2023 |e 11 |b 03 |c 11 |h 2203-2214 | ||