Temporal Trends in Emergency Department Utilization for Opioid Use Disorder in Baltimore, Maryland
Author(s)
Seyedmohammad Shams, PhD1, Colleen Ennett, PhD1, Martha Jurczak, MFA2, Lisa Pineles, PhD2, Justin Brooks, MD, PhD2, Bradley Maron, MD, FAHA2, Zafar Zafari, PhD2;
1University of Maryland Medical System, Baltimore, MD, USA, 2University of Maryland Institute for Health Computing, North Bethesda, MD, USA
1University of Maryland Medical System, Baltimore, MD, USA, 2University of Maryland Institute for Health Computing, North Bethesda, MD, USA
Presentation Documents
OBJECTIVES: Opioid use disorder (OUD) is common in Baltimore, Maryland and is associated with decreased longevity. The availability of pharmacotherapies that prevent OUD-associated emergencies has increased steadily. Thus, we hypothesized that Baltimore OUD-emergency department (ED) events have decreased longitudinally over a period defined by greater availability of OUD therapies.
METHODS: The frequency of OUD-associated ED visits involving ambulance transportation occurring daily in the University of Maryland System (UMMS), which includes two hospitals in Baltimore City, was analyzed retrospectively between January 1, 2016-June 30, 2024. The Seasonal Autoregressive Integrated Moving Average with eXogenous factors model (SARIMAX), which incorporates both non-seasonal and seasonal factors, was used to process data from 2016-2023 and predict OUD-ED visits in January-June 2024. Data are presented as mean standard error (SE), and differences in event frequency between years were calculated using the Mann-Whitney U test. The mean absolute percentage error (MAPE) was used for SARIMAX prediction.
RESULTS: Compared to 2016, we observed a steady and significant annual increase in daily OUD-ED encounters through 2019 (1.56±0.07 vs. 2.05±0.09 vs. 2.48±0.1 vs. 2.52±0.1 encounters, p_values<0.05). We observed a subsequent, sharp decline in which the annual OUD-ED rate was 1.92 ± 0.07, 1.73±0.07, and 1.38 ± 0.07 for 2020, 2021, and 2022, respectively, coinciding with the COVID-19 pandemic. However, a recurrent rise in daily OUD-ED incidence was observed beginning late 2022 and increased continuously to an average of 1.69 ± 0.08 in late 2023. There was strong concordance between our SARIMAX prediction and the observed daily incidence rate of OUD-ED for January-June 2024 (2.02±0.02 vs. 2.03±0.1; MAPE=6.1%).
CONCLUSIONS: We observed a progressive increase in OUD-ED events in Baltimore from 2016 through 2024, which was disrupted temporarily during COVID-19 years. These data suggest that prospective strategies focusing on city-wide implementation of pharmacotherapies to prevent OUD emergencies in Baltimore are warranted.
METHODS: The frequency of OUD-associated ED visits involving ambulance transportation occurring daily in the University of Maryland System (UMMS), which includes two hospitals in Baltimore City, was analyzed retrospectively between January 1, 2016-June 30, 2024. The Seasonal Autoregressive Integrated Moving Average with eXogenous factors model (SARIMAX), which incorporates both non-seasonal and seasonal factors, was used to process data from 2016-2023 and predict OUD-ED visits in January-June 2024. Data are presented as mean standard error (SE), and differences in event frequency between years were calculated using the Mann-Whitney U test. The mean absolute percentage error (MAPE) was used for SARIMAX prediction.
RESULTS: Compared to 2016, we observed a steady and significant annual increase in daily OUD-ED encounters through 2019 (1.56±0.07 vs. 2.05±0.09 vs. 2.48±0.1 vs. 2.52±0.1 encounters, p_values<0.05). We observed a subsequent, sharp decline in which the annual OUD-ED rate was 1.92 ± 0.07, 1.73±0.07, and 1.38 ± 0.07 for 2020, 2021, and 2022, respectively, coinciding with the COVID-19 pandemic. However, a recurrent rise in daily OUD-ED incidence was observed beginning late 2022 and increased continuously to an average of 1.69 ± 0.08 in late 2023. There was strong concordance between our SARIMAX prediction and the observed daily incidence rate of OUD-ED for January-June 2024 (2.02±0.02 vs. 2.03±0.1; MAPE=6.1%).
CONCLUSIONS: We observed a progressive increase in OUD-ED events in Baltimore from 2016 through 2024, which was disrupted temporarily during COVID-19 years. These data suggest that prospective strategies focusing on city-wide implementation of pharmacotherapies to prevent OUD emergencies in Baltimore are warranted.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EPH186
Topic
Epidemiology & Public Health
Disease
SDC: Mental Health (including addition)