Structural and Social Determinants of Opioid Abuse Among Florida-Based Hospitals

Donald R. Haley, Hanadi Hamadi, Jing Xu, Mei Zhao, Anh Viet Tran Nguyen, Dayana Martinez

Producción científica: Articlerevisión exhaustiva

Resumen

Background: With over two million people suffering from opioid abuse disorders, the Centers for Medicare and Medicaid Services has identified opioid abuse as a key priority. Florida is one of eight states labeled as a high-burden opioid abuse and is an “epicenter” for opioid use and misuse.

Purpose: The purpose of this study was to discover potential predictors of opioid abuse in Florida by exploring specific healthcare delivery, geographic, and patient demographic factors.

Methods : A retrospective longitudinal study design was used to examine four years (2014-2017) of Florida inpatient administrative discharge data across 173 hospitals of opioid abuse rate. Main measures included, opioid abuse counts (n=12,804) defined using both ICD-9-CM and ICD-10-CM systems. Negative binomial regression was used to estimate the association between hospital factors, county factor, and opioid abuse hospital rates.

Results: We found a statistically significant association between hospital opioid abuse count and hospital size, location, teaching status, patients’ average age, gender, and race. The estimated probability of opioid abuse for a patient if treated in a large hospital is 0.23 (about 23%), significantly higher than small (8%) and medium (17%) size hospitals. The estimated probability of opioid abuse for a patient if treated in a rural hospital is 0.12 (about 12%), while in an urban hospital is higher at 0.17 (about 17%). The risk ratio is 0.71, which means the risk decreased by two-thirds when treated in rural hospitals. We also found that hospitals with a younger patient population, a higher percent of males and a higher proportion of Caucasian patients, are at a higher risk for an increase in opioid abuse counts.

Discussion: These findings provide policymakers with crucial insight into Florida’s opioid crisis and the identification of predictive factors that contribute to opioid abuse.

Idioma originalAmerican English
PublicaciónFlorida Public Health Review
Volumen17
N.º1
EstadoPublished - jun 21 2020

Disciplines

  • Community Health and Preventive Medicine
  • Health Services Administration
  • Health Services Research
  • Public Health
  • Social and Behavioral Sciences

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