OBJECTIVES:

Due to widespread prescribing of opioids for pain management during last three decades and associated misuse, opioid use disorder (OUD) has become a public health crisis in the United States (US) and contributes to substantial morbidity and mortality. This study assessed burden of OUD on US hospital systems using current national data.

METHODS:

A retrospective cross-sectional study was performed using PINC AI™ Healthcare Database (PHD) data for adult patients (Age≥18 years) treated in hospital outpatient Emergency Department (ED) or inpatient wards between January 1, 2017 and March 31, 2022. We defined OUD using ICD-10-CM discharge diagnosis codes F11.xxx. Prevalence of OUD and mean hospital total cost for OUD-related visits were estimated for ED and inpatients separately. National cost for OUD visits was extrapolated using prevalence and mean cost of OUD visits derived from PHD sample and national ED and inpatient visit estimates from the most recent National Hospital Ambulatory Medical Care Survey and American Hospital Association Annual survey data.

RESULTS:

OUD prevalence was 0.58% among 79,924,272 ED visits and 2.28% among 30,253,922 inpatient visits, which remained stable throughout the study period. Both prevalence rates were highest among Native Americans and higher among patients treated in Disproportionate Share Hospitals and urban hospitals. Patients with OUD were 5-9 years younger, more likely to be Native American, on Medicaid, uninsured, homeless, and less likely to be discharged home versus those without OUD. Mean visit cost was higher among patients with OUD than those without (ED: $1,264 vs $853; Inpatients: $15,763 vs $14,510) (All p<0.01). Annual national cost of hospital outpatient ED and inpatient visits for OUD patients was estimated to be over $95.4 billion, accounting for 7.86% of total hospital expenses in 2020.

CONCLUSIONS:

OUD is associated with substantial healthcare costs and disproportionately affects patients with lower socioeconomic status and Native Americans.