Table 3. Opioid Prescribing Rates and Amounts for Postsurgical Pain Management Among Patients Not Receiving Long-term Opioid Therapy in the US, by Indication and Insurance Type, 2017a,b.
| Procedure | Private insurancec | Medicaidd | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|
| Procedures with Rx, No. (%) [95% CI] | No. of days’ supply | Daily dosage, MME | Procedures with Rx, No. (%) [95% CI] | No. of days’ supply | Daily dosage, MME | |||||
| Mean (95% CI) | Median (IQR) | Mean (95% CI) | Median (IQR) | Mean (95% CI) | Median (IQR) | Mean (95% CI) | Median (IQR) | |||
| Vaginal delivery | 14 166 (23.6) [23.3-23.9] | 4.1 (4.1-4.1) | 4.0 (3.0-5.0) | 39.0 (38.8-39.3) | 37.5 (27.0-50.0) | 35 208 (30.7) [30.4-30.9] | 4.2 (4.2-4.2) | 4.0 (3.0-5.0) | 38.2 (38.0-38.4) | 33.3 (25.0-45.0) |
| Total knee arthroplasty | 27 528 (79.5) [79.1-79.9] | 8.5 (8.5-8.6) | 8.0 (5.0-10.0) | 62.0 (61.6-62.3) | 57.7 (37.5-85.7) | 2753 (85.7) [84.5-86.9] | 8.3 (8.2-8.5) | 7.0 (5.0-10.0) | 61.1 (60.0-62.3) | 55.6 (30.9-85.7) |
| Sinus surgery | 21 661 (63.5) [63.0-64.0] | 4.9 (4.8-4.9) | 4.0 (3.0-5.0) | 42.2 (41.9-42.6) | 40.0 (30.0-50.0) | 5905 (59.8) [58.9-60.8] | 5.3 (5.2-5.4) | 5.0 (3.0-7.0) | 39.9 (39.2-40.6) | 37.5 (25.0-50.0) |
| Cholecystectomy, laparoscopic | 23 664 (80.2) [79.7-80.6] | 4.7 (4.7-4.8) | 4.0 (3.0-5.0) | 42.1 (41.8-42.3) | 37.5 (28.6-50.0) | 14 081 (87.6) [87.1-88.2] | 4.8 (4.7-4.8) | 4.0 (3.0-5.0) | 42.3 (42.0-42.6) | 37.5 (25.0-50.0) |
| Cesarean section | 24 247 (78.0) [77.6-78.5] | 4.9 (4.9-5.0) | 5.0 (3.0-5.0) | 48.5 (48.2-48.7) | 45.0 (31.5-60.0) | 42 560 (83.3) [83.0-83.6] | 5.1 (5.1-5.1) | 5.0 (4.0-6.0) | 49.3 (49.1-49.5) | 45.0 (32.1-60.0) |
| Total hip arthroplasty | 14 375 (76.4) [75.8-77.0] | 8.4 (8.3-8.4) | 7.0 (5.0-10.0) | 57.6 (57.1-58.0) | 50.0 (31.3-80.0) | 1745 (83.4) [81.8-85.0] | 8.4 (8.2-8.6) | 7.0 (5.0-10.0) | 61.6 (60.0-63.3) | 56.3 (30.8-85.7) |
| Lumpectomy or partial mastectomy | 6355 (69.8) [68.9-70.8] | 4.2 (4.2-4.3) | 4.0 (3.0-5.0) | 37.4 (37.0-37.9) | 33.3 (25.0-50.0) | 2073 (81.0) [79.5-82.5] | 4.7 (4.6-4.8) | 5.0 (3.0-5.0) | 37.3 (36.5-38.1) | 32.5 (25.0-45.0) |
| Combined spinal fusion and lumbar decompression surgery | 10 620 (75.5) [74.8-76.2] | 9.5 (9.4-9.7) | 8.0 (5.0-10.0) | 63.5 (62.5-64.4) | 57.1 (35.0-85.7) | 1796 (74.1) [72.3-75.8] | 8.9 (8.6-9.2) | 8.0 (5.0-10.0) | 62.9 (60.4-65.4) | 56.3 (33.3-85.7) |
| Lumbar decompression | 11 844 (86.0) [85.4-86.6] | 8.1 (8.0-8.1) | 7.0 (5.0-10.0) | 53.9 (53.5-54.4) | 45.0 (30.0-67.5) | 1987 (81.9) [80.4-83.5] | 8.1 (7.9-8.3) | 7.0 (5.0-10.0) | 50.1 (49.0-51.3) | 45.0 (30.0-64.3) |
| Arthroscopic rotator cuff repair | 12 538 (93.0) [92.6-93.5] | 6.6 (6.6-6.7) | 5.0 (5.0-8.0) | 62.6 (62.1-63.1) | 60.0 (40.0-84.4) | 1837 (94.4) [93.4-95.4] | 7.3 (7.1-7.4) | 7.0 (5.0-10.0) | 56.4 (55.3-57.6) | 50.0 (30.0-75.0) |
| Spinal fusion | 9206 (81.3) [80.6-82.0] | 9.0 (8.9-9.1) | 8.0 (5.0-10.0) | 58.4 (57.7-59.0) | 50.0 (31.3-75.0) | 3136 (78.5) [77.2-79.8] | 9.1 (8.9-9.2) | 8.0 (5.0-10.0) | 54.7 (53.7-55.8) | 45.0 (30.0-75.0) |
| Tonsillectomy | 6229 (44.2) [43.3-45.0] | 7.2 (7.1-7.4) | 7.0 (5.0-9.0) | 42.2 (41.5-42.9) | 34.6 (19.3-59.1) | 12 800 (35.9) [35.4-36.4] | 7.4 (7.3-7.5) | 7.0 (5.0-10.0) | 27.3 (27.0-27.7) | 21.4 (12.5-35.0) |
| Abdominal solid organ resection, laparoscopic | 10 197 (85.9) [85.3-86.5] | 5.0 (4.9-5.0) | 5.0 (3.0-6.0) | 46.2 (45.7-46.6) | 45.0 (30.0-56.3) | 4531 (92.4) [91.7-93.2] | 5.1 (5.0-5.2) | 5.0 (3.0-7.0) | 46.7 (46.0-47.3) | 45.0 (30.0-60.0) |
| Appendectomy, laparoscopic | 8649 (69.0) [68.2-69.8] | 4.6 (4.5-4.6) | 4.0 (3.0-5.0) | 42.4 (42.0-42.8) | 37.5 (30.0-50.0) | 5605 (64.9) [63.8-65.9] | 4.5 (4.4-4.5) | 4.0 (3.0-5.0) | 36.9 (36.3-37.4) | 30.0 (20.4-45.0) |
| Inguinal hernia repair, open | 8250 (78.0) [77.2-78.8] | 4.9 (4.8-4.9) | 5.0 (3.0-5.0) | 43.0 (42.6-43.5) | 40.0 (30.0-50.0) | 2580 (61.9) [60.5-63.4] | 5.0 (4.9-5.1) | 5.0 (3.0-6.0) | 34.6 (33.7-35.5) | 30.0 (15.0-46.9) |
| Excisional biopsy | 2148 (48.5) [47.0-49.9] | 5.1 (4.9-5.2) | 5.0 (3.0-6.0) | 41.1 (39.9-42.3) | 35.0 (27.0-50.0) | 1051 (49.5) [47.4-51.7] | 5.1 (4.9-5.3) | 5.0 (3.0-7.0) | 37.9 (36.6-39.3) | 30.0 (20.8-45.0) |
| Coronary artery bypass | 2835 (34.8) [33.7-35.8] | 7.2 (7.0-7.3) | 6.0 (5.0-9.0) | 44.0 (43.2-44.9) | 40.0 (30.0-56.3) | 463 (39.8) [37.0-42.6] | 7.1 (6.7-7.5) | 7.0 (5.0-9.0) | 46.8 (44.1-49.6) | 42.9 (28.6-57.1) |
| Inguinal hernia repair, laparoscopic | 6614 (83.0) [82.2-83.9] | 4.8 (4.7-4.8) | 4.0 (3.0-5.0) | 45.3 (44.8-45.8) | 45.0 (30.0-56.3) | 1040 (79.1) [77.0-81.3] | 5.2 (5.0-5.3) | 5.0 (3.0-7.0) | 42.9 (41.5-44.3) | 40.0 (25.0-56.3) |
| Simple mastectomy | 2096 (83.3) [81.9-84.8] | 5.5 (5.3-5.6) | 5.0 (4.0-7.0) | 51.1 (49.8-52.4) | 45.0 (30.0-64.3) | 338 (87.3) [84.0-90.7] | 5.6 (5.2-6.0) | 5.0 (4.0-7.0) | 48.6 (45.6-51.7) | 45.0 (30.0-60.0) |
| Arthroscopic knee surgery | 6887 (92.9) [92.3-93.5] | 6.2 (6.2-6.3) | 5.0 (4.0-7.0) | 60.9 (60.3-61.6) | 56.3 (40.0-75.0) | 3021 (92.1) [91.2-93.0] | 6.8 (6.7-6.9) | 6.0 (5.0-8.0) | 54.0 (53.1-55.0) | 46.9 (30.0-75.0) |
| Colectomy, laparoscopic | 2316 (60.4) [58.9-62.0] | 5.3 (5.2-5.4) | 5.0 (3.0-7.0) | 45.8 (44.9-46.8) | 43.8 (30.0-56.3) | 403 (64.6) [60.8-68.3] | 5.5 (5.2-5.8) | 5.0 (4.0-7.0) | 50.4 (47.6-53.2) | 45.0 (30.0-60.0) |
| Parathyroid or thyroid surgery | 3057 (71.1) [69.8-72.5] | 4.8 (4.7-4.8) | 4.0 (3.0-5.0) | 41.7 (41.0-42.4) | 37.5 (30.0-50.0) | 1267 (81.8) [79.9-83.7] | 5.2 (5.0-5.3) | 5.0 (3.0-7.0) | 43.1 (41.9-44.3) | 37.5 (28.6-50.0) |
| Cholecystectomy, open | 512 (50.5) [47.4-53.6] | 5.4 (5.1-5.6) | 5.0 (3.0-6.0) | 41.3 (39.5-43.0) | 37.5 (28.1-50.0) | 234 (58.9) [54.1-63.8] | 5.3 (4.9-5.6) | 5.0 (3.0-7.0) | 45.2 (42.4-48.1) | 38.8 (28.1-60.0) |
| Colectomy, open | 1196 (34.8) [33.2-36.4] | 5.7 (5.5-5.9) | 5.0 (4.0-7.0) | 43.5 (42.2-44.9) | 37.5 (28.1-50.0) | 422 (35.6) [32.9-38.4] | 5.5 (5.3-5.7) | 5.0 (3.0-7.0) | 48.9 (45.8-52.1) | 41.7 (28.6-60.0) |
Abbreviations: IQR, interquartile range; MME, morphine milligram equivalents16; Rx, prescriptions.
a
Reported outcome data (prescribing rate, MME, and days’ supply) reflect Rx supplied for a specific procedure or visit, meaning that the prescribing rate is anchored to visits or procedures.
b
Patients whose Rx do not meet LTOT criteria.
c
Data from the OptumLabs Data Warehouse, 2017.
d
Data from the MarketScan Multi-State Medicaid Database, from quarter 4 2016 to quarter 3 2017.