Table 2.
Rate of Filling a Prescription for Opioids within 7 Days after Emergency Department Visit and Rate of Long-Term Use, According to Opioid Prescribing Intensity of Physician Seen.*
| Variable | Initial Rate of Opioid Prescription in Emergency Department | Rate of Long-Term Use | |||
|---|---|---|---|---|---|
| Average Rate | Low-Intensity Prescriber | High-Intensity Prescriber | Low-Intensity Prescriber | High-Intensity Prescriber | |
| percent | |||||
| Overall rate of opioid prescribing | 14.7 | 7.3 | 24.1 | 1.16 | 1.51 |
|
| |||||
| Rate of prescribing according to patient characteristic | |||||
|
| |||||
| Age | |||||
| <65 yr | 17.9 | 8.8 | 28.9 | 2.09 | 2.82 |
| 65–74 yr | 16.4 | 8.4 | 26.4 | 0.86 | 1.00 |
| 75–84 yr | 12.3 | 6.0 | 20.4 | 0.68 | 0.89 |
| ≥85 yr | 8.9 | 4.3 | 15.6 | 0.86 | 1.01 |
|
| |||||
| Sex | |||||
| Male | 15.1 | 7.6 | 24.7 | 1.22 | 1.53 |
| Female | 14.4 | 7.1 | 23.8 | 1.13 | 1.51 |
|
| |||||
| Race | |||||
| White | 14.6 | 7.5 | 23.7 | 1.16 | 1.50 |
| Black | 14.9 | 6.8 | 25.0 | 1.38 | 1.87 |
|
| |||||
| Medicare–Medicaid dual eligibility | |||||
| No | 14.4 | 7.4 | 23.4 | 0.71 | 0.87 |
| Yes | 15.0 | 7.2 | 24.8 | 1.62 | 2.17 |
|
| |||||
| No. of chronic conditions† | |||||
| 0 | 18.7 | 9.5 | 29.9 | 1.29 | 1.73 |
| 1 or 2 | 16.9 | 8.5 | 27.4 | 1.07 | 1.52 |
| ≥3 | 13.3 | 6.5 | 22.0 | 1.17 | 1.48 |
|
| |||||
| Alzheimer’s disease | |||||
| No | 15.9 | 8.0 | 25.9 | 1.15 | 1.52 |
| Yes | 8.5 | 4.0 | 14.7 | 1.19 | 1.49 |
|
| |||||
| Disabled | |||||
| No | 13.4 | 6.7 | 22.1 | 0.71 | 0.87 |
| Yes | 17.0 | 8.3 | 27.5 | 1.95 | 2.59 |
|
| |||||
| Depression | |||||
| No | 14.8 | 7.4 | 24.2 | 0.78 | 1.01 |
| Yes | 14.5 | 7.1 | 23.9 | 1.74 | 2.28 |
|
| |||||
| Census region | |||||
| Northeast | 11.9 | 5.2 | 20.5 | 0.78 | 1.11 |
| Midwest | 14.0 | 6.9 | 23.4 | 1.27 | 1.45 |
| South | 15.9 | 8.4 | 25.3 | 1.33 | 1.81 |
| West | 16.2 | 7.7 | 26.7 | 1.07 | 1.44 |
|
| |||||
| Emergency department visit for injury‡ | |||||
| No | 13.7 | 6.7 | 22.7 | 1.16 | 1.53 |
| Yes | 23.7 | 12.6 | 35.8 | 1.14 | 1.42 |
Long-term opioid use was defined as 6 months of days of opioids supplied in the 12 months after an index emergency department visit, excluding the first 30 days after the index emergency department visit.
The number of chronic conditions among 11 possible conditions is shown. These conditions are the following: acute myocardial infarction, Alzheimer’s dementia, atrial fibrillation, cerebrovascular disease, chronic kidney disease, chronic obstructive pulmonary disease, congestive heart failure, depression, diabetes, hyperlipidemia, and hypertension.
An emergency department visit for an injury was defined as any emergency department visit with an “E” code associated with an injury (according to the codes in the International Classification of Diseases, 9th Revision). Of patients who visited an emergency department for a reason other than an injury, 195,651 saw low-intensity prescribers and 144,895 saw high-intensity prescribers. Of patients who visited an emergency department because of an injury, 20,027 saw low-intensity prescribers and 17,056 saw high-intensity prescribers.