TABLE 1.
Adolescent and Young Adult Visit Characteristics Compared by Opioid Administration (ED-RX) and Prescribing (DC-RX) in EDs; NHAMCS 2014–2018
| Unweighted No. Visits | Weighted Visits, % (95% CI) | Weighted Visits for ED-RX, % (95% CI)* |
P † | Weighted Visits for DC-RX, % (95% CI)* | P † | |
|---|---|---|---|---|---|---|
| Total | 12,693 | 12.2 (11.4–13.0) | 12.3 (11.3–13.3) | 11.5 (10.5–12.5) | ||
| Demographics | ||||||
| Age, mean (95% CI) | 18.2 (SE = 0.08) | 19.6 (19.3–19.9) | <0.001 | 20.1 (19.9–20.4) | <0.001 | |
| Sex | 0.10 | 0.10 | ||||
| Female | 7430 | 58.6 (57.2–59.9) | 11.8 (10.5–13.0) | 11.0 (9.9–12.0) | ||
| Male | 5263 | 41.4 (40.1–42.8) | 13.0 (11.7–14.3) | 12.1 (10.7–13.6) | ||
| Race | 0.08 | 0.02 | ||||
| White | 8794 | 70.7 (67.5–73.9) | 12.8 (11.7–14.0) | 12.2 (10.9–13.4) | ||
| Other | 3899 | 29.3 (26.1–32.5) | 11.0 (9.3–12.7) | 9.8 (8.3–11.3) | ||
| Ethnicity | 0.09 | 0.02 | ||||
| Hispanic or Latino | 2356 | 17.4 (15.0–19.7) | 10.6 (8.5–12.7) | 9.4 (7.6–11.2) | ||
| Not Hispanic or Latino | 10,337 | 82.6 (80.3–85.0) | 12.6 (11.6–13.7) | 11.9 (10.8–13.0) | ||
| Primary payer | 0.001 | <0.001 | ||||
| Blank/Unknown | 1120 | 9.0 (6.8–11.3) | 11.8 (8.0–15.6) | 7.8 (5.7–9.9) | ||
| Private insurance | 4040 | 31.0 (29.2–32.9) | 13.4 (11.7–15.1) | 13.0 (11.1–14.9) | ||
| Medicare/Medicaid/State-Based | 5727 | 44.0 (41.4–46.6) | 10.3 (9.0–11.6) | 9.1 (8.0–10.1) | ||
| Other | 1806 | 15.9 (14.1–17.7) | 15.9 (13.2–18.6) | 17.2 (14.9–19.5) | ||
| Geographic region | <0.001 | <0.001 | ||||
| Northeast | 2393 | 15.2 (12.5–17.9) | 6.5 (5.1–7.9) | 4.7 (3.6–5.8) | ||
| Midwest | 3283 | 27.3 (22.3–32.3) | 12.1 (10.2–14.0) | 10.8 (8.5–13.1) | ||
| South | 4416 | 38.8 (33.8–43.8) | 13.5 (11.8–15.3) | 14.2 (12.7–15.8) | ||
| West | 2604 | 18.8 (15.8–21.7) | 14.8 (12.4–17.1) | 12.3 (10.7–13.8) | ||
| Year | <0.001 | <0.001 | ||||
| 2014 | 3066 | 20.7 (17.7–23.8) | 14.5 (12.4–16.6) | 16.1 (13.5–18.8) | ||
| 2015 | 2875 | 21.3 (18.5–24.0) | 14.9 (12.5–17.2) | 14.0 (11.6–16.3) | ||
| 2016 | 2429 | 21.1 (18.3–23.9) | 11.4 (9.5–13.3) | 11.3 (9.5–13.1) | ||
| 2017 | 2049 | 20.2 (17.1–23.4) | 10.9 (8.8–13.1) | 9.0 (7.1–10.8) | ||
| 2018 | 2274 | 16.7 (14.0–19.3) | 9.0 (7.0–11.1) | 5.7 (4.1–7.3) | ||
| Visit characteristics | ||||||
| Hospital type | 0.10 | 0.10 | ||||
| Pediatric ED | 186 | 1.0 (0.1–1.9) | 8.3 (4.0–12.7) | 4.0 (0.0–9.6) | ||
| General ED | 12,507 | 99.0 (98.1–99.9) | 12.3 (11.3–13.4) | 11.5 (10.5–12.5) | ||
| Immediacy with which to be seen | <0.001 | 0.9 | ||||
| Unknown/Blank/No triage | 2270 | 17.2 (13.1–21.2) | 12.7 (10.1–15.3) | 11.3 (8.2–14.3) | ||
| Urgent/Emergent/Immediate | 5017 | 40.3 (37.6–43.0) | 8.3 (7.2–9.5) | 11.4 (9.8–13.0) | ||
| Semiurgent/Nonurgent | 5406 | 42.6 (39.5–45.7) | 15.9 (14.5–17.3) | 11.6 (10.3–12.8) | ||
| Patient preexisting conditions | ||||||
| Asthma | 0.04 | 0.07 | ||||
| No | 11,134 | 88.1 (87.1–89.1) | 12.6 (11.4–13.7) | 11.8 (10.7–12.9) | ||
| Yes | 1559 | 11.9 (10.9–12.9) | 10.2 (8.3–12.1) | 9.2 (6.9–11.5) | ||
| Depression | 0.40 | 0.003 | ||||
| No | 11,730 | 97.0 (96.3–97.7) | 12.4 (11.3–13.4) | 11.8 (10.8–12.8) | ||
| Yes | 963 | 3.0 (2.3–3.7) | 11.1 (8.3–13.9) | 7.3 (4.8–9.8) | ||
| Obesity | 0.09 | 0.20 | ||||
| No | 12,387 | 97.0 (96.3–97.7) | 12.2 (11.2–13.2) | 11.4 (10.4–12.4) | ||
| Yes | 306 | 3.0 (2.3–3.7) | 16.7 (10.9–22.4) | 14.7 (8.7–20.7) | ||
| Providers seen | ||||||
| ED attending physician | <0.001 | 0.70 | ||||
| No | 1813 | 17.4 (14.3–20.4) | 8.0 (6.4–9.7) | 11.9 (8.8–15.0) | ||
| Yes | 10,880 | 82.6 (79.6–85.7) | 13.2 (12.1–14.3) | 11.4 (10.4–12.4) | ||
| Consulting physician | <0.001 | 0.80 | ||||
| No | 11,829 | 93.8 (92.9–94.8) | 11.8 (10.8–12.8) | 11.5 (10.5–12.5) | ||
| Yes | 864 | 6.2 (5.2–7.1) | 20.0 (16.3–23.7) | 11.1 (7.3–14.9) | ||
| Imaging Ordered | ||||||
| CT scan (any) | <0.001 | <0.001 | ||||
| No | 11,367 | 88.7 (87.7–89.8) | 10.0 (9.1–10.8) | 10.5 (9.5–11.6) | ||
| Yes | 1326 | 11.3 (10.2–12.3) | 30.7 (27.2–34.1) | 18.7 (16.0–21.4) | ||
| X-ray | <0.001 | <0.001 | ||||
| No | 9108 | 70.0 (68.8–71.3) | 10.8 (9.7–11.9) | 9.7 (8.8–10.7) | ||
| Yes | 3585 | 30.0 (28.7–31.2) | 15.9 (14.1–17.6) | 15.5 (13.5–17.5) | ||
| Ultrasound | <0.001 | 0.60 | ||||
| No | 11,915 | 93.8 (92.9–94.6) | 11.5 (10.5–12.5) | 11.4 (10.4–12.4) | ||
| Yes | 778 | 6.2 (5.4–7.1) | 24.0 (19.2–28.7) | 12.2 (9.5–14.9) | ||
| Nonopioid analgesics ordered | 0.20 | 0.01 | ||||
| No | 8049 | 62.4 (60.9–63.9) | 11.8 (10.5–13.1) | 10.6 (9.4–11.7) | ||
| Yes | 4644 | 37.6 (36.1–39.1) | 13.1 (11.5–14.6) | 13.0 (11.3–14.6) | ||
| Pain score, mean (95% CI) | 5.0 (4.9–5.1) | 7.4 (7.2–7.6) | <0.001 | 7.0 (6.8–7.3) | <0.001 | |
*Reflects row percentages.
†P values correspond to weighted t tests and Rao-Scott χ2 tests, where appropriate.