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Association Between Opioid Use Disorder and Healthcare Spending and Utilization in Emergency Surgical Patients: A
Anjali A Dixit1, Pooja A Lagisetty2,3, Michelle C Odden4
1From the Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, CA.
Summary
Opioid use disorder (OUD) in surgical patients increases post-discharge healthcare spending and utilization. Opioid agonist treatment (OAT) may mitigate these increased costs and utilization for patients with OUD.
Area of Science:
- Health Economics
- Surgical Care
- Addiction Medicine
Background:
- Patients with opioid use disorder (OUD) present unique challenges in postoperative pain management and risk of relapse.
- Understanding healthcare spending and utilization patterns in this population is crucial for optimizing perioperative care.
Purpose of the Study:
- To determine the association between opioid use disorder (OUD) and healthcare spending and utilization in emergency surgical patients.
- To evaluate if opioid agonist treatment (OAT) modifies the relationship between OUD and healthcare outcomes.
Main Methods:
- A retrospective analysis of 142,726 emergency surgical patients from January 1, 2016, to December 31, 2021.
- Estimation of associations between OUD and spending (during admission and 90-day postdischarge) and healthcare utilization.
- Evaluation of OAT's impact on OUD-related outcomes.
Main Results:
- No significant difference in spending during surgical admission between patients with and without OUD.
- Patients with OUD experienced 38% higher post-discharge spending ($2,560 incremental cost).
- Elevated post-discharge utilization, including inpatient days (IRR=1.90) and 30-day readmissions (IRR=1.30), observed in patients with OUD.
Conclusions:
- Emergency surgical patients with OUD incur higher post-discharge healthcare costs and utilization, suggesting increased complication risks.
- Preoperative optimization with OAT may lead to improved perioperative outcomes and cost savings for patients with OUD.
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