Table 1.
Naloxone and buprenorphine prescribing within 30 days of an ED visit for opioid overdose, August 4, 2019-April 3, 2021, Symphony Health Integrated Dataverse
| Group | Number of ED visits for opioid overdose (% of sample)a | Naloxone prescribing rateb | Buprenorphine prescribing rateb | ||
|---|---|---|---|---|---|
| Number | Number | % (95% CI)b | Number | % (95% CI) b | |
| All ED visits for opioid overdose | 148,966 (100.0%) | 11,010 | 7.4% (7.3%–7.5%) | 12,608 | 8.5% (8.3%–8.6%) |
| Sex | |||||
| Female | 53,073 (35.6%) | 7,070 | 7.4% (7.2%–7.7%) | 4,021 | 7.6% (7.4%–7.8%) |
| Male | 95,893 (64.4%) | 3,940 | 7.4% (7.2%–7.5%) | 8,587 | 9.0% (8.8%–9.1%) |
| Age group c | |||||
| 0–17 | 3,525 (2.4%) | 149 | 4.2% (3.6%–4.9%) | 36 | 1.0% (0.7%–1.1%) |
| 18–25 | 20,539 (13.8%) | 1,742 | 8.5% (8.1%–8.7%) | 1,648 | 8.0% (7.7%–8.4%) |
| 26–34 | 42,150 (28.3%) | 3,382 | 8.0% (7.8%–8.3%) | 4,725 | 11.2% (10.9%–11.5%) |
| 35–44 | 31,868 (21.4%) | 2,342 | 7.3% (7.1%–7.6%) | 3,233 | 10.1% (9.8%–10.5%) |
| 45–54 | 22,447 (15.1%) | 1,592 | 7.1% (6.8%–7.4%) | 1,696 | 7.6% (7.2%–7.9%) |
| 55–64 | 19,824 (13.3%) | 1,331 | 6.7% (6.4%–7.1%) | 1,042 | 5.3% (5.0%–5.6%) |
| 65–74 | 6,615 (4.4%) | 398 | 6.0% (5.4%–6.6%) | 213 | 3.2% (2.8%–3.7%) |
| 75 and older | 1,855 (1.2%) | 74 | 4.0% (3.1%–4.9%) | 15 | 0.8% (0.5%–1.3%) |
| Unknown | 143 (0.1%) | 0d | 0.0% (0.0%–0.0%) | 0d | 0.0% (0.0%–0.0%) |
| Method of payment for ED visit | |||||
| Commercial | 97,113 (65.2%) | 6,791 | 7.0% (6.8–7.2%) | 8,407 | 8.7% (8.5%–8.8%) |
| Medicare | 8,405 (5.6%) | 594 | 7.1% (6.5%–7.6%) | 7,957 | 5.3% (4.9%–5.8%) |
| Medicaid | 39,847 (26.7%) | 3,431 | 8.6% (8.3%–8.9%) | 3,561 | 8.9% (8.7%–9.2%) |
| Cash | 994 (0.7%) | 64 | 6.4% (4.9%–8.0%) | 949 | 4.5% (3.2%–5.8%) |
| Other government | 1,201 (0.8%) | 58 | 4.8% (3.7%–6.2%) | 43 | 3.6% (2.5%–4.6%) |
| Unknown | 1,406 (0.9%) | 72 | 5.1% (4.0–6.3%) | 104 | 7.4% (6.1%–8.9%) |
| Region of patient residence | |||||
| Northeast | 35,784 (24.0%) | 3,121 | 8.7% (8.4%–9.0%) | 3,977 | 11.1% (10.8%–11.4%) |
| Midwest | 46,931 (31.5%) | 3,222 | 6.9% (6.6%–7.1%) | 4,396 | 9.4% (9.1%–9.6%) |
| South | 43,312 (29.1%) | 2,881 | 6.7% (6.4%–6.9%) | 2,900 | 6.7% (6.5%–6.9%) |
| West | 19,994 (13.4%) | 1,678 | 8.4% (8.0%–8.8%) | 1,233 | 6.2% (5.8%–6.5%) |
| Unknown | 2,945 (2.0%) | 108 | 3.7% (3.0%–4.4%) | 102 | 3.5% (2.8%–4.1%) |
ED – emergency department
Defined as the proportion of visits with ≥1 pharmacy claim for the medication within 30 days, regardless of whether the claim was paid and resulted in dispensing
The percentages in the first column are column percentages (i.e., the percentage of the 148,966 visits in the sample), while those in the second and third columns are row percentages (i.e., percentage of visits in the group).
Mean age was 39.5 years (SD 14.7), but a caveat is that age is top-coded in the data, so the true mean is higher.
It is unclear whether these 143 visits truly had no naloxone or buprenorphine prescribing within 30 days or whether this reflect data error. We retained these visits in the sample rather than excluding them owing to our desire to avoid sample exclusions for the purpose of modeling trends in ED visits for opioid overdose. Excluding these visits would have changed results minimally because they were infrequent.