TABLE 1.
Characteristics of cohort of beneficiaries enrolled in the North Carolina Medicaid “lock-in” program, October 2009-June 2013, and by latent class of log average daily morphine milligram equivalents (MMEs) of dispensed opioid trajectories
| Total Cohort (n=2,701) |
Start high, end high (C1) (n=353.0; 13.1%)† |
Start medium, end medium (C2) (n=357.6; 13.2%)† |
Start medium, end low (C3) (n=581.3; 21.5%)† |
Start low, end medium (C4) (n=609.4; 22.6%)† |
Start low, end low (C5) (n=799.8; 29.6%)† |
|
|---|---|---|---|---|---|---|
| N (%) for categorical variables; Mean (25th pct, median, 75th pct) for continuous variables | ||||||
| DEMOGRAPHICS ‡ | ||||||
| Age (years) | 38.7 (30, 38, 47) | 43.6 (37, 44, 52) | 43.6 (36, 44, 51) | 39.5 (31, 39, 47) | 38.6 (31, 38, 46) | 33.9 (27, 32, 40) |
| Gender | ||||||
| Women | 1,896 (70.2) | 216.2 (61.3) | 233.3 (65.3) | 386.9 (66.6) | 446.3 (73.2) | 613.3 (76.7) |
| Men | 805 (29.8) | 136.8 (38.8) | 124.2 (34.7) | 194.4 (33.4) | 163.1 (26.8) | 186.5 (23.3) |
| Race | ||||||
| White | 1,999 (74.0) | 268.0 (75.9) | 246.4 (68.9) | 424.8 (73.1) | 433.4 (71.1) | 626.4 (78.3) |
| Black | 550 (20.4) | 66.9 (19.0) | 86.3 (24.1) | 116.6 (20.1) | 133.6 (21.9) | 146.5 (18.3) |
| Other | 152 (5.6) | 18.0 (5.1) | 24.9 (7.0) | 39.9 (6.9) | 42.3 (7.0) | 26.9 (3.4) |
| Urbanicity of county of residence | ||||||
| Counties in metro areas of ≥ 1 mill. pop. | 675 (25.0) | 65.9 (18.7) | 86.1 (24.1) | 137.5 (23.7) | 161.4 (26.5) | 224.1 (28.0) |
| Counties in metro areas of < 1 mill. pop. | 1,268 (47.0) | 180.8 (51.3) | 162.3 (45.4) | 269.7 (46.4) | 276.9 (45.4) | 378.3 (47.3) |
| Nonmetro, urban pop. of ≥ 20,000 | 444 (16.4) | 54.2 (15.4) | 73.3 (20.5) | 102.8 (17.7) | 111.7 (18.3) | 102.0 (12.8) |
| Nonmetro, urban pop. of <20,000 or rural pop. | 314 (11.6) | 51.9 (14.7) | 35.9 (10.1) | 71.4 (12.3) | 59.3 (9.7) | 95.4 (11.9) |
| Medicaid eligibility category | ||||||
| Aid to families with dependent children | 1,389 (51.4) | 119.4 (33.8) | 135.5 (37.9) | 267.0 (45.9) | 347.9 (57.1) | 519.2 (64.9) |
| Aid to disabled | 1,282 (47.5) | 232.5 (65.9) | 219.0 (61.3) | 311.2 (53.5) | 259.6 (42.6) | 259.7 (32.5) |
| Aid for other reasons (e.g., aid to blind) | 30 (1.1) | 1 (0.3) | 3.0 (0.8) | 3.2 (0.6) | 1.9 (0.3) | 20.9 (2.6) |
| SUBSTANCE USE-RELATED§ | ||||||
| Alcohol-related disorder | 174 (6.4) | 18.5 (5.3) | 30.8 (8.6) | 38.4 (6.6) | 35.0 (5.7) | 51.2 (6.4) |
| Other substance-related disorder | 870 (32.2) | 110.3 (31.2) | 82.7 (23.1) | 214.7 (36.9) | 171.9 (28.2) | 290.4 (36.3) |
| Medication-assisted treatment (MAT) | 273 (10.1) | 7.5 (2.1) | 4.1 (1.1) | 43.8 (7.5) | 37.7 (6.2) | 180.0 (22.5) |
| Medication or drug-related overdose | 193 (7.2) | 29.8 (8.4) | 23.1 (6.5) | 58.2 (10.0) | 33.0 (5.4) | 49.0 (6.1) |
| HEALTH CARE UTILIZATION § | ||||||
| Number of unique pharmacies from which Medicaid-reimbursed prescriptions were obtained |
4.2 (2, 4, 6) | 3.7 (2, 3, 5) | 4.0 (2, 4, 5) | 4.4 (3, 4, 6) | 4.3 (3, 4, 6) | 4.2 (3, 4, 5) |
| Emergency department visits | 9.9 (3, 6, 13) | 5.5 (1, 3, 7) | 9.4 (2, 5, 12) | 10.8 (3, 7, 14) | 10.3 (3, 7, 13) | 11.3 (4, 8, 14) |
| Inpatient admissions | 1.3 (0, 1, 2) | 1.6 (0, 1, 2) | 1.5 (0, 1, 2) | 1.6 (0, 1, 2) | 1.2 (0, 1, 2) | 1.0 (0, 1, 1) |
| PAIN-RELATED DIAGNOSES § | ||||||
| Any joint pain or arthritis | 2,452 (90.8) | 325.4 (92.2) | 338.9 (94.8) | 549.3 (94.5) | 571.7 (93.8) | 666.7 (83.4) |
| Back pain | 2,253 (83.4) | 308.4 (87.4) | 309.0 (86.4) | 504.3 (86.8) | 535.0 (87.8) | 596.3 (74.6) |
| Neck pain | 1,124 (41.6) | 141.4 (40.1) | 165.4 (46.3) | 252.9 (43.5) | 277.3 (45.5) | 287.1 (35.9) |
| Headache/migraine pain | 589 (21.8) | 63.3 (17.9) | 80.1 (22.4) | 131.6 (22.6) | 146.5 (24.0) | 167.5 (21.0) |
| Fibromyalgia, chronic pain, or fatigue | 1,443 (53.4) | 261.1 (74.0) | 230.8 (64.5) | 363.1 (62.5) | 353.5 (58.0) | 234.6 (29.3) |
| Rheumatoid arthritis or osteoarthritis | 706 (26.1) | 144.5 (41.0) | 139.0 (38.9) | 168.0 (28.9) | 160.0 (26.3) | 94.4 (11.8) |
| Sickle cell | 50 (1.9) | 17.3 (4.9) | 9.8 (2.7) | 11.7 (2.0) | 10.0 (1.6) | 1.2 (0.2) |
| MENTAL HEALTH-RELATED DIAGNOSES § | ||||||
| Depression | 1,675 (62.0) | 193.6 (54.9) | 221.6 (62.0) | 364.0 (62.6) | 388.0 (63.7) | 508.8 (63.5) |
| Anxiety disorder | 1,184 (43.8) | 123.2 (34.9) | 136.6 (38.2) | 288.6 (49.6) | 275.7 (45.2) | 360.0 (45.0) |
| Other serious mental health disorder (e.g., bipolar, schizophrenia) | 751 (27.8) | 59.5 (16.9) | 71.6 (20.0) | 189.1 (32.5) | 172.9 (28.4) | 257.9 (32.3) |
| COMORBID CONDITION INDEX§ | ||||||
| Mean Charlson comorbidity index | 0.92 (0, 0, 1) | 1.31 (0, 1, 2) | 1.20 (0, 1, 2) | 0.98 (0, 0, 1) | 0.93 (0, 0, 1) | 0.57 (0, 0, 1) |
pct= percentile; C= class
†
Counts, percentages, and means are weighted by beneficiaries’ posterior probabilities for belonging to a given class
‡
Assessed at the time of “lock-in” program enrollment
§
Assessed using a one-year lookback period from the date of “lock-in” program enrollment