Surgeon Bias in Postoperative Opioid Prescribing

Area of Science:

• Medical Research
• Public Health
• Surgical Practice

Background:

• Opioid misuse is a national crisis driven by prescription medications.
• Provider prescribing habits vary significantly.
• Understanding predictors of opioid prescribing is crucial.

Purpose of the Study:

• Identify patient and surgeon characteristics influencing postoperative opioid prescribing.
• Analyze factors associated with opioid prescription amounts after surgery.

Main Methods:

• Serial cross-sectional analysis of 20,497 general surgery patients.
• Primary outcome: total opioids prescribed within 30 days post-surgery.
• Linear regression models used to identify associated patient and provider characteristics.

Main Results:

• Patient age, sex, ethnicity, and insurance status significantly associated with opioid amounts.
• Younger and male patients received higher morphine milligram equivalents (MMEs).
• Hispanic patients received significantly lower opioid prescriptions compared to Non-Hispanic patients.
• Surgeon sex and years in practice predicted opioid amounts; surgeons <15 years in practice prescribed highest MMEs.

Conclusions:

• Opioid prescribing post-surgery exhibits significant variability and potential bias.
• Key predictors identified include patient demographics and surgeon experience.
• Surgeons tend to prescribe more opioids to younger, male patients and certain ethnic groups.
• Less experienced surgeons prescribe higher MME amounts.