National hospital care survey demonstration projects : opioid-involved emergency department visits, hospitalizations, and deaths
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National hospital care survey demonstration projects : opioid-involved emergency department visits, hospitalizations, and deaths

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    Objective—This report demonstrates the utility of linking the restricted-use 2014 National Hospital Care Survey (NHCS), 2014–2015 National Death Index (NDI), and 2014–2015 Drug-Involved Mortality (DIM) data to study opioid-involved emergency department (ED) visits, hospitalizations, and mortality within 1 year post-discharge. Example research questions and unweighted results are presented. Results are not nationally representative. Methods—Patient records from the 2014 NHCS with sufficient identifying information were linked to the 2014–2015 NDI and DIM data. Visits were considered opioid-involved if they had International Classification of Diseases, Ninth Revision, Clinical Modification (ICD–9–CM) diagnosis codes 304.00–304.02, 304.70–304.72, 305.50–305.52, 760.72, 965.00–965.02, 965.09, 970.1, or E850.0–E850.2 in any diagnosis or external cause of injury code field. Opioid-involved drug overdose deaths were deaths with an International Classification of Diseases, 10th Revision (ICD–10) underlying cause-of-death code of X40–44, X60–64, X85, or Y10–Y14 and a multiple cause code of T40.0–T40.4 or T40.6. Results—In the 2014 NHCS, there were 15,495 patients with an opioid-involved ED-only visit and 24,059 patients with an opioid-involved hospitalization. Of the 20,962 patients with an opioid-involved hospitalization eligible to be linked to NDI, 1,805 died (9%) within 1 year of discharge. Of these deaths, 341 (19%) resulted from a drug overdose. Of drug overdose deaths, 243 (71%) involved an opioid, where 12% died within 30 days post-discharge, 19% within 31–90 days, and 69% within 91–365 days. Opioids most frequently mentioned included heroin (46%), fentanyl (20%), oxycodone (13%), methadone (12%), and morphine (12%). These categories are not mutually exclusive because a death may involve more than one drug. For approximately 22% of patients who died of an opioid-involved drug overdose in 2014, their last ED-only visit or hospitalization was opioid-involved. Conclusion—While the NHCS data are not nationally representative, these unlinked and linked National Center for Health Statistics data allow for exploratory analyses of ED visits, hospitalizations, and associated mortality outcomes. Suggested citation: Spencer MR, Flagg LA, Jackson G, DeFrances C, Hedegaard H. National Hospital Care Survey demonstration projects: Opioid-involved emergency department visits, hospitalizations, and deaths. National Health Statistics Reports; no 141. Hyattsville, MD: National Center for Health Statistics. 2020. CS316560 nhsr141-508.pdf
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