Hospitalizations for Endocarditis and Associated Health Care Costs Among Persons with Diagnosed Drug Dependence — North Carolina, 2010–2015

Abstract

What is already known about this topic? Injection drug use and opioid dependence have increased to epidemic levels in the United States, and evidence suggests that bacterial complications of injection drug use, such as endocarditis, are increasing. What is added by this report? In North Carolina, analysis of hospital discharge data identified an approximately twelvefold increase in hospitalizations for endocarditis combined with drug dependence during 2010-2015. Consistent with overall trends in the U.S. opioid epidemic, the majority of patients were non-Hispanic, white, aged <40 years, and from rural areas; in addition, approximately one third were infected with hepatitis C virus. On average, the cost for each hospitalization for endocarditis exceeded $50,000, and 42% of hospitalizations were among persons on Medicaid or without insurance. The total hospital costs of hospitalizations for drug dependence-associated endocarditis increased eighteenfold during 2010-2015. What are the implications for public health practice? As the U.S. opioid epidemic continues to grow, hospitalizations for infectious complications associated with injection drug use are likely to increase. Effective and cost-saving public health interventions, such as syringe service programs and harm reduction strategies, are needed to reduce disease burden and save health care costs. Collaboration between public health, health care systems, and policy makers is important to reduce the risks associated with injection drug use.