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New PHC4 Report Shows Opioids Contributed to One in 37 PA Hospitalizations During 2017

October 16, 2018

The Pennsylvania Health Care Cost Containment Council (PHC4) today released a research brief detailing trends related to the opioid crisis in Pennsylvania. The report found that hospitalizations related to opioids—primary and co-occurring conditions—accounted for one in 37 hospitalizations during 2017.

It also found that government payers—Medicaid and Medicare—covered more than 70 percent of Pennsylvania’s opioid-related hospitalizations last year. For reference, Medicaid covered 16.9 percent of all hospitalizations last year, but 44.3 percent of all opioid-related hospitalizations. Medicaid covers provides coverage for lower-income Pennsylvanians, pregnant women, the elderly, and those with disabilities. This is consistent with HAP’s research confirming the essential role Medicaid plays in assuring Pennsylvanians’ access to health care services generally and in addressing the opioid crisis specifically. 

PHC4’s report further noted 3,500 hospitalizations for opioid overdose (as the primary diagnosis), and 2,736 hospitalizations for opioid use disorder (as primary diagnosis) in 2017. Additionally, it identified 30,476 admissions for other conditions with OUD as a co-occurring condition; this accounted for 83 percent of all opioid-related hospitalizations. In these cases, OUD commonly presented alongside primary diagnoses such as mental health disorders, substance use disorders, and skin infections (which often appeared at drug injection sites).

The report also found higher rates of opioid-related admissions—as compared with the statewide average—among the 35–54 age group, those in areas with average household incomes below $30,000, and Pennsylvanians in urban counties. 

Hospital emergency departments are on the front lines of the opioid crisis, and hospital staff see first-hand the effects that OUD can have on patients and their families. HAP and Pennsylvania’s hospital community continue to partner with state and local governments, and a variety of organizations across the commonwealth to work to stem the tides of the opioid crisis; however OUD is a chronic condition that requires a long-term management and access to a variety of treatment options, including detox treatments, physical health care, and behavioral health services. Hospitals are taking the lead on key programs such as warm hand-off protocols, prescription guidelines, and drug takeback boxes. Additionally, hospitals are working to develop research-based best practices for medication-assisted treatment, advocating for additional funding for inpatient and outpatient behavioral health treatment, and providing patients with pain management alternatives.

For more information about this report or the Pennsylvania hospital community’s efforts to address the opioid crisis, please contact Michael J. Consuelos, MD, HAP’s senior vice president, clinical integration; Jennifer Jordan, HAP’s vice president, regulatory advocacy; or Sari Siegel, PhD, HAP’s vice president, health care research.

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