Presentation (CTI)

OBJECTIVES: Opioid use disorder (OUD) among pregnant women is associated with severe maternal and neonatal outcomes. Kentucky has some of the highest OUD rates in the US. Medications for Opioid Use Disorder (MOUD) can significantly mitigate these adverse outcomes. This study aimed to estimate the prevalence of OUD among pregnant women across Kentucky Medicaid regions, analyze the utilization of MOUD during these pregnancies, and visualize the geographic distribution of both disease burden and treatment access.
METHODS: We analyzed Kentucky Medicaid Claims Data from 2016 to 2022. We utilized the Chronic Conditions Data Warehouse (CCW) algorithms to identify pregnancies complicated by OUD, individuals who received any MOUD, and those with at least two MOUD claims. The specific combination of ICD-10 diagnosis, NDC, and procedure codes used in this analysis represents a novel approach in this context.
RESULTS: OUD was reported in 7.01% of all identified pregnancies during the study period. There was substantial regional variation, ranging from 3.69% in Region 1 (a north-central region centered by the City of Louisville) to 13.02% in Region 8. Regarding treatment, 65.82% of OUD-affected pregnancies had at least one claim for MOUD. Coverage was lowest in Region 3 (53.18%) and highest in Region 8 (71.93%). When defining active treatment as two or more MOUD claims, the statewide rate was 46.69%. This metric also varied substantially by geography, with Region 3 showing the lowest sustained utilization (27.28%) and Region 8 the highest (56.83%).
CONCLUSIONS: The prevalence of OUD among pregnant Medicaid beneficiaries in Kentucky remains high, with the most significant burden concentrated in the state’s Appalachian and rural regions. Conversely, urban centers demonstrated the lowest rates. Encouragingly, our findings indicate that regions with the highest prevalence of OUD also had the highest rates of treatment coverage, suggesting that resources are reaching the areas of greatest need.