Article Analysis – Health Care Burden Associated With Outpatient Opioid Use Following Inpatient Or Outpatient Surgery
Course Number and Title
Brummett, C. M., England, C., Evans-Shields, J., Kong, A. M., Lew, C. R., Henriques, C., … & Oderda, G. (2019). Health care burden associated with outpatient opioid use following inpatient or outpatient surgery. Journal of Managed Care & Specialty Pharmacy, 25(9), 973-983.
The use of prescribed opioids to treat postsurgical pain has been linked to long-term opioid dependence and increased healthcare consumption and expenses. The study’s primary objective was to compare the cost of health care for opioid-naive adult patients prescribed opioids following major surgery to opioid-naive adult patients not prescribed opioids. Data from IBM Watson Health MarketScan Research Database was utilized in the study. The eligibility criteria for the participants included opioid-naïve adult patients who had undergone major surgery, whether inpatient or outpatient, with at least one year of continuous admission, prior to and after the index surgery. During the post-index period, acute medical outcomes, opioid use, healthcare utilization, and costs were assessed; however, index surgery hospitalization and day of index outpatient surgery were excluded. The study results indicate that opioid users were younger, more likely to be female, and had a larger preoperative comorbidity load than nonopioid users across all three payers (commercial, Medicare, Medicaid). Opioid users had increased hospitalizations, emergency department visits, and pharmacy claims. In conclusion, a year following inpatient or outpatient surgery, filling an outpatient opioid prescription was linked to higher health care utilization and costs across all payers.
The research is relevant to the study of our health systems in various ways. First, it involves utilizing health care services among inpatient and outpatient individuals who have undergone surgery. Second, it seeks to assess acute medical outcomes, opioid use, healthcare utilization, and costs. Chapter 5 of the textbook looks at inpatient and outpatient services. The difference between inpatient and outpatient care is that inpatient services are provided while a patient is admitted to the hospital and has to stay overnight while an outpatient receives care without admission to the hospital. Inpatients and outpatients have different health needs, and thus, the cost of accessing health care may differ even if the patients have a similar condition. Those admitted to the hospital will receive higher billing than outpatients.
Opioid addiction is a major issue in the community, and many patients who have received surgery have fallen into opioid addiction. According to the article, opioid use was common to both inpatient and outpatient after discharge but was less common among Medicare patients as compared to commercial and Medicaid insurance. The finding of study concluded that filing an outpatient opioid prescription was associated with cost and increased healthcare utilization. This implies that individuals who frequently sought health care services had a higher chance of applying for opioid medications. In the same case, if the cost of the opioid medication was cheap, more patients would seek to fill prescriptions.
The article is right regarding the utilization of opioid medication in health care. Many people go to a hospital without a drug addiction problem, but after prescription, they end up becoming addicted, and this increases their opioid use. According to the article, most of the individuals who participated in the study had never had an opioid problem, but soon after their first surgery, regardless of whether they were admitted or not, as long as they were prescribed some opioid medication, they ended up depending on them a year after discharge. This is a major problem in the hospitals as it cannot be considered as a healthcare utilization, but a drug den, where the people filling the opioid prescriptions are already healed but depend on the medication for their daily routines. It is advisable that pharmacists or health institutions find an alternative to pain-relieving medication which is not addictive to avoid making patients slaves to opioids.