PHS29 - Geographic Variation in Opioid Related Outpatient Healthcare Utilization in the United States: A Retrospective Study of a Large Health System’s Claims Data

Abstract

The abuse and dependence on opioids has been on the rise nationally. However, the impact of opioid use on healthcare utilization varies widely across the United States. The objective was to estimate the geographic variation in costs and payments associated with outpatient opioid-related visits in a large hospital claims database. The Vizient Health System Database was used to identify opioid-related outpatient patient visits between January 2014 and June 2017. This database includes detailed billing data across all payers for more than 400 hospitals across the US. Eligible visits had a primary diagnosis of opioid use or dependence defined by International Classification of Diseases, 9th and 10th Revision (ICD-9/10). Geography was defined the 9 US Census sub-regions. Multivariable regression models were performed to estimate the mean expected cost and payment per visit for each region controlling for patient demographics, comorbid conditions, hospital characteristics, and year. A total of 160,901 hospital outpatient visits were identified in 447 hospitals. The overall adjusted mean cost and payment for an opioid visit was $533 and $374, respectively. The adjusted mean expected cost was $488, $408, $395, $569, $429, $610, $698, $530, $802 in East North Central, East South Central, Mid-Atlantic, Mountain, New England, Pacific, South Atlantic, West North Central, and West South Central regions, respectively. The adjusted mean expected payment was $281, $527, $187, $319, $245, $574, $434, $567, $476 East North Central, East South Central, Mid-Atlantic, Mountain, New England, Pacific, South Atlantic, West North Central, and West South Central regions, respectively. The cost and payment of treating an opioid related visit were highest in West South Central region and West North Central, respectively. The costs associated with the visit were typically higher than the average payment. Opioid-related visits are a highly prevalent and costly epidemic placing a large burden on US hospitals.