Table 1.
Opioid Overdose Index Stay Factors Associated With Readmissions, Healthcare Cost and Utilization Project National Readmissions Database, 2016
| Readmissions ≤90 days among patients with non-fatal index staysa January-December 2016 (N=58,850) |
||||||
|---|---|---|---|---|---|---|
| Opioid overdose |
Other (non-opioid overdose) |
|||||
| Index stay measure | Patients with index stay discharged January–September 2016, n (%) | All-cause, n (%)b | n (%)b | AOR (95% CI) | n (%)b | AOR (95% CI) |
| Sample size | 61,170 (100.0) | 14,351 (24.4) | 1,658 (2.8) | NA | 13,311 (22.6) | NA |
| Age, years | 46.8 (0.19)c | 51.7 (0.24)c | 48.5 (0.66)c | 1.01 (1.00,1.01) | 52.1 (0.25)c | 1.01 (1.00, 1.01) |
| Female | 30,630 (50.1) | 7,528 (25.4) | 723 (2.4) | 0.79 (0.69, 0.92) | 7,088 (23.9) | 0.98 (0.92,1.05) |
| Comorbiditiesd | ||||||
| Drug abuse | 27,771 (45.4) | 6,525 (24.5) | 946 (3.5) | 1.47 (1.22,1.77) | 5,926(22.2) | 1.15 (1.08,1.24) |
| Fluid and electrolyte disorders | 27,558 (45.1) | 6,695 (25.9) | 794 (3.1) | 1.11 (0.93, 1.33) | 6,183 (24.0) | 0.94 (0.88, 1.00) |
| Hypertension | 25,205 (41.2) | 7,488 (30.7) | 697 (2.9) | 0.90 (0.74,1.09) | 7,093 (29.0) | 1.21 (1.11,1.32) |
| Depression | 19,371 (31.7) | 4,542 (23.9) | 531 (2.8) | 1.12 (0.94, 1.35) | 4,205 (22.1) | 0.94 (0.88, 1.02) |
| Chronic pulmonary disease | 15,812 (25.8) | 4,949 (32.2) | 540 (3.5) | 1.32 (1.09,1.59) | 4,659 (30.3) | 1.30 (1.21,1.39) |
| Other neurologic disorders | 12,838 (21.0) | 3,439 (27.8) | 381 (3.1) | 1.13 (0.93, 1.38) | 3,216 (26.0) | 1.09 (1.01, 1.18) |
| Alcohol abuse | 9,997 (16.3) | 2,387 (24.7) | 296 (3.1) | 1.03 (0.83, 1.28) | 2,199 (22.8) | 1.08 (0.99,1.18) |
| Deficiency anemias | 9,323 (15.2) | 2,934 (32.8) | 286 (3.2) | 1.10 (0.89, 1.36) | 2,776 (31.0) | 1.31 (1.20,1.44) |
| Psychoses | 7,960 (13.0) | 2,159 (27.9) | 260 (3.4) | 1.25 (1.01,1.53) | 2,018 (26.0) | 1.22 (1.11,1.34) |
| Obesity | 7,750 (12.7) | 2,073 (27.7) | 161 (2.2) | 0.74 (0.57, 0.94) | 1,999 (26.7) | 0.97 (0.89, 1.07) |
| Other comorbidities | 27,766 (45.4) | 8,582 (32.2) | 855 (3.2) | 1.27 (1.06,1.54) | 8,109 (30.5) | 1.61 (1.50,1.73) |
| None | 2,690 (4.4) | 293 (11.1) | 45 (1.7) | 1.07 (0.63, 1.82) | 254 (9.7) | 0.77 (0.62, 0.95) |
| Heroin overdose | 17,110 (28.0) | 3,160 (19.8) | 617 (3.9) | 1.67 (1.37, 2.04) | 2,731 (17.1) | 0.88 (0.81, 0.96) |
| Detoxification or rehabilitation services | 1,812 (3.0) | 448 (24.8) | 51 (2.8) | 0.89 (0.59, 1.35) | 425 (23.5) | 1.26 (1.04, 1.52) |
| Discharge status | ||||||
| Routine | 38,807 (63.4) | 8,512 (21.9) | 1,084 (2.8) | ref | 7,804 (20.1) | ref |
| Transfers | 10,014 (16.4) | 2,718 (27.1) | 222 (2.2) | 0.74 (0.59, 0.93) | 2,604 (26.0) | 1.12 (1.03,1.22) |
| Home health care | 5,182 (8.5) | 1,899 (36.6) | 156 (3.0) | 0.95 (0.71,1.27) | 1,811 (35.0) | 1.38 (1.25, 1.52) |
| Against medical advice | 4,771 (7.8) | 1,206 (25.3) | 190 (4.0) | 1.29 (1.02,1.64) | 1,080 (22.6) | 1.30 (1.14,1.48) |
| Died in hospital | 2,320 (3.8) | NA | NA | NA | NA | NA |
| Discharged alive, destination unknown | 76 (0.1) | NR | NR | 2.60 (0.93, 7.32) | NR | 0.74 (0.35, 1.55) |
| Primary payer | ||||||
| Medicare | 20,902 (34.2) | 6,546 (32.3) | 670 (3.3) | 1.77 (1.34, 2.35) | 6,169 (30.4) | 1.53 (1.37,1.71) |
| Medicaid | 18,521 (30.3) | 4,345 (24.6) | 575 (3.3) | 1.54 (1.21,1.96) | 3,995 (22.6) | 1.54 (1.40, 1.70) |
| Private | 12,572 (20.6) | 1,996 (16.4) | 216 (1.8) | ref | 1,834 (15.1) | ref |
| Self-pay | 6,470 (10.6) | 947 (15.4) | 145 (2.4) | 1.10 (0.76, 1.59) | 827 (13.4) | 1.01 (0.87, 1.16) |
| Othere | 1,907 (3.1) | 365 (20.0) | NR | 0.57 (0.32, 1.03) | 355 (19.4) | 1.19 (0.99,1.42) |
| No charge | 683 (1.1) | 131 (19.7) | 29 (4.3) | 1.91 (1.05, 3.50) | 114 (17.1) | 1.30 (0.92, 1.83) |
| Unknown | 115 (0.2) | NR | NR | 0.71 (0.11, 4.54) | NR | 1.03 (0.54, 1.96) |
Note: 2016 Healthcare Cost and Utilization Project National Readmissions Database. All data reflect Index stay survey weights. Logistic regression model Included all factors reported In the table. Boldface Indicates statistical significance (p<0.05).
Survey-weighted estimates of the number of patients readmitted ≤90 days (i.e., either a patient was readmitted during that period or not). Each patient is counted only once in each readmission category: Any, opioid overdose, non-opioid overdose. Analysis details: Index stays defined using HCUP-NRD variable DQTR=1–3 for stays with qualifying opioid overdose diagnosis codes (Figure 1). Readmissions per patient (NRD_VisitLInk) defined as all NRD_DaysToEvent ≤90 of the value of NRD_DaysToEvent plus length of stay (LOS) for the index stay.
Data are % of patients with non-fatal index stay discharges (n=58,850; excluding patients that died during the index stay [n=2,320, reported in the table]) by measure (or, table row) that had readmissions ≤90 days.
Data are mean (SE).
Comorbidities affecting ≥10% of index stay patients reported.
Includes Worker’s Compensation, CHAMPUS, CHAMPVA, Title V, and other government programs.
NA, not applicable; NR, not reported (when relative SE was >30% or the SE=0 the survey-weighted estimate was considered unreliable).