Insurance-Associated Disparities in Opioid Use and Misuse Among Patients Undergoing Gynecologic Surgery for Benign...

Area of Science:

• Health Services Research
• Pharmacology
• Public Health

Background:

• Opioid prescribing patterns and outcomes can differ based on insurance status.
• Gynecologic surgery presents a significant opportunity for perioperative opioid exposure.
• Understanding disparities in opioid use is crucial for equitable patient care.

Purpose of the Study:

• To compare perioperative and persistent postoperative opioid use between Medicaid-insured and commercially insured women.
• To investigate the association between insurance type and the development of opioid use disorder (OUD) after gynecologic surgery.

Main Methods:

• Retrospective analysis of the Truven Health MarketScan database (2012-2016).
• Inclusion of opioid-naïve women (18-64 years) undergoing benign gynecologic surgery.
• Defined persistent opioid use as prescription fills 90-180 days post-surgery; OUD defined by specific healthcare utilization.

Main Results:

• Medicaid-insured women (N=31,155) received greater opioid quantities and durations than commercially insured women (N=270,716).
• Persistent postoperative opioid use was significantly higher in Medicaid-insured women (14.1%) versus commercially insured women (5.8%).
• Medicaid patients with persistent opioid use were twice as likely to develop OUD (16.8% vs 5.1%).

Conclusions:

• Medicaid insurance is associated with increased perioperative opioid exposure and persistent postoperative use in women undergoing gynecologic surgery.
• Women with Medicaid insurance face a higher risk of developing opioid use disorder following surgery.
• Findings highlight significant insurance-associated disparities in opioid management and outcomes.