OBJECTIVES : This study aimed to identify factors associated with prescribing opioids at discharge among patients who underwent surgeries during hospitalization and associated medical expenses in the years 2011 -2015.

METHODS : Medical conditions, full-year consolidated data, prescribed medicine files, and hospital inpatient expense files of the Medical Expenditure Panel Survey (MEPS) in the years 2011-2015 were used. The target population was patients who underwent surgery. A comparison was performed between patients who were prescribed opioids at discharge and those who were not. Estimated days on opioids was calculated using 90 milligram morphine equivalents daily. Outcomes included length of stay, cost, and other visits associated with this encounter. All analytical procedures were performed using SAS version 9.4.

RESULTS : Patients who were prescribed opioids at discharge had a shorter hospital stay (3-4 days vs. 4-5 days) and fewer charges for the condition compared to those did not. However, patients who were not prescribed opioids had more complex medical conditions (high blood pressure, coronary heart disease, angina, heart attack, stroke, emphysema, high cholesterol, and diabetes diagnoses). A higher number of office-based visits and a higher number of prescribed medicines were associated with opioid prescriptions for postoperative pain. Patients who were opioid naïve were more likely to stay on opioids for 5-6 days for the condition, while those who used opioids before the surgery needed opioids for 2-4 weeks.

CONCLUSIONS : Patients who underwent surgeries and were discharged in 3-4 days were more likely to use prescribed opioids for postoperative pain. The total days on the prescribing opioids varied between opioid-naïve and opioid-tolerant patients. Findings confirmed the suggestion from the CDC that rarely do patients need more than seven days for acute severe pain. Further guidelines/standardized treatment plans are needed for postoperative pain management of opioid-tolerant patients.