Pattern and burden of opioid-related hospitalizations in the USA from 2016 to 2018

Abstract

Aims: The current opioid crisis in the USA is a formidable challenge for the healthcare system, and the general population. Our objective is to characterize the burden of opioid-related disorders in an inpatient setting in the USA for the years 2016, 2017 and 2018 using the National Inpatient Sample (NIS). Methods: A cross-sectional analysis of the NIS was performed to identify and analyse hospitalizations with an opioid-related diagnosis in 2016, 2017 and 2018. Descriptive statistics and regression models were utilized to define the demographics of the population of interest and measure the outcomes. Results: We identified 962 900 discharges with opioid-related diagnosis in 2016, 982 710 in 2017 and 942 110 in 2018. The majority were age <60 years, were found in residents of low-income zip codes and covered by Medicaid. The adjusted mean total hospitalization cost trended up from $12 828 (95% confidence interval [CI] 12 547–13 108) in 2016, to $13164.9 (95% CI 12 872.47–13 457.34) in 2017 and then to $13 626.65 (95% CI 13 325.95–13 927.34) in 2018. The adjusted mortality was highest in 2016; 2.26% (95% CI 2.16–2.35) and it trended down to 1.97% (95% CI 1.88–2.05) in 2017, and to 1.89% (95% CI 1.81–1.98) in 2018. Conclusions: Opioid-related disorders cause a significant number of hospitalizations in the USA. A large proportion of these patients are age <60 years, have lower household income, and are covered by Medicaid. Programmes directed towards this specific group can help reduce the overall burden of hospitalizations.