Objectives: The objectives were (1) to describe the frequency of patient encounters with opioid use disorders (OUDs) by census divisions; and (2) to identify how census divisions impact patients’ reduced encounters of OUDs.

Methods: Using Health Facts® database, patient encounters were included if the patient (1) was 18 years old or greater; (2) had an index encounter; (3) survived at least 30 days after the discharge. The encounter of an OUD was based on ICD-10 codes. The date at which a patient first had an OUD encounter was the index date. For the first objective, the unit of analysis was a patient encounter. Patient characteristics were age, gender, marital status, race, health insurance coverage, discharge disposition, and patient type. Facility characteristics were care setting, medical specialty, census region, census division, urban vs. rural, acute vs. non-acute, and teaching hospital status. For the second objective, the unit of analysis was a patient. Patients were examined one year prior to through one year after the index date. A logistic regression was used to determine the likelihood of reduced encounters over time, conditional upon selected patient and facility characteristics.

Results: A total of 265,643 patient encounters were identified, and Census Division 6 (East South Central) was associated with the highest frequency of OUDs among 9 census divisions. In the logistic regression (n=10, 762), among facility characteristics, emergency room, psychiatry, Census Division 3 (East North Central), Census Division 4 (West North Central), and urban areas were significant positive predictors, whereas Census Division 8 (Mountain) was a significant negative predictor.

Conclusions: Census Division 6 was associated with the highest frequency of OUDs. Compared with Census Division 6, Census Divisions 3 and 4 had a significantly positive impact on fewer encounters of OUDs, whereas Census Division 8 had a significantly negative impact.