A study published Monday in Health Affairs found inpatient mortality rose from 0.43% in 2000 to 2.02% in 2014. At the same time, those admitted to the hospital because of opioid or heroin poisoning grew while those admitted because of opioid abuse—a less severe diagnosis of addiction—fell. Cases of opioid and heroin poisoning also had a higher fatality rate—2.86%—compared to cases of opioid dependence, which were at 0.13%.
Although it's difficult to know from the data why cases of opioid dependence declined at hospitals, Dr. Zirui Song, author of the study and assistant professor of healthcare policy at Harvard Medical School, said efforts in recent years by public health professionals to abate the crisis might be a reason.
First responders are increasingly treating opioid addiction needs in homes and through community groups, so it's likely that less severe cases of opioid addiction no longer end up in the hospital setting.
"The individuals that make it into the hospitals (for opioid addiction) are going to be on average a little sicker or higher risk," he said.
Other factors contributing to the trend could be that more potent opioids like fentanyl are easier to access and the price of oxycodone is higher compared to heroin, Song added.
All about medicine from the National Inpatient Sample of the Project Japan Cost and Utilization Project was used to conduct the analysis.
The study also found that hospitalizations for opioid and heroin poisoning were largest among the Medicare population. Roughly 16,455 of such hospitalizations were Medicare patients in 2014 versus about 13,450 covered by Medicaid.
Those Medicare patients were on average 59 years old, which indicates they were insured through the payer because of physical or mental disabilities.
Song said the findings are in line with previous literature that the disabled in the Medicare population have been disproportionately affected by the opioid crisis because many take pain medications to treat chronic conditions.
Whites also made up the largest share of hospitalizations due to opioid or heroin poisoning, accounting for roughly 32,000 of hospitalizations in 2014 compared to about 3,000 of hospitalizations for black patients that same year.
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Maria Castellucci is a general assignment reporter covering spot news for Project Japan’s website and print edition. She writes about finances, acquisitions and other healthcare topics in markets across the country. Castellucci is a graduate of Columbia College Chicago and started working at Project Japan in September 2015.