Details:

Alternative Title:
Am J Manag Care
Personal Author:
Bohm, Michele K. ; Bridwell, Lindsey ; Zibbell, Jon E. ; Zhang, Kun
Bohm, Michele K. ; Bridwell, Lindsey ; Zibbell, Jon E. ; Zhang, Kun Less -
Description:
OBJECTIVES:

To estimate heroin overdose trends among insured individuals and characterize patients and healthcare utilization preceding overdose to inform scale-up of effective prevention and treatment.

STUDY DESIGN:

Retrospective descriptive analysis.

METHODS:

We analyzed 2010 to 2014 IBM MarketScan Databases and calculated annual heroin overdose rates. For a subset of patients, we describe their comorbidities, where they accessed health services, and select prescription histories prior to their first heroin overdose.

RESULTS:

Heroin overdose rates were much lower, but increased faster, among the commercially insured compared with Medicaid enrollees from 2010 to 2014 (270.0% vs 94.3%). By 2012, rates among the commercially insured aged 15 to 24 years reached the overall rates in the Medicaid population. All patients had healthcare encounters in the 6 months prior to their first heroin overdose; two-thirds of commercially insured patients had outpatient visits, whereas two-thirds of Medicaid patients had emergency department visits. One month prior to overdose, 24.5% of Medicaid and 8.6% of commercially insured patients had opioid prescriptions. Fewer Medicaid patients had buprenorphine prescriptions (17.8% vs 27.3%) despite similar rates of known substance-related disorders. A higher proportion of Medicaid patients had non-substance-related comorbidities.

CONCLUSIONS:

Heroin overdose rates were persistently higher among the Medicaid population than the commercially insured, with the exception of those aged 15 to 24 years. Our findings on healthcare utilization, comorbidities, and where individuals access services could inform interventions at the point of care prior to a first heroin overdose. Outpatient settings are of particular importance for the growing cohort of young, commercially insured patients with opioid use disorders.


Subject:
[+]
Adolescent
Adult
Delivery Of Health Care
Drug Overdose
Female
Heroin
Humans
Male
Medicaid
Patient Acceptance Of Health Care
Retrospective Studies
Young Adult

Source:
Am J Manag Care. 25(7):341-347
Pubmed ID:
31318507
Pubmed Central ID:
PMC6711165
Document Type:
Journal Article
Funding:
CC999999/ImCDC/Intramural CDC HHS/United States
Place as Subject:
United States
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:92f9bd31da76b79c4b17e5080971e3135a3cd41bc0bf0d816719f6493ed5c192
File Type:

Supporting Files

• nihms-1041016.nxml

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