Mortality Quadrupled Among Opioid-Driven Hospitalizations, Notably Within Lower-Income And Disabled White Populations
Mortality Quadrupled Among Opioid-Driven Hospitalizations, Notably Within Lower-Income And Disabled White Populations
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DOI：
10.1377/hlthaff.2017.0689
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发表时间：
2017-12-01
期刊：
影响因子：
9.7
通讯作者：
Song, Zirui
中科院分区：
文献类型：
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作者：
Song, Zirui
医院在目前的阿片类药物危机中在照顾患者方面发挥着重要作用，但美国缺乏关于阿片类药物驱动的住院治疗的结果和组成的数据。1993-2014年期间，来自全国住院患者样本的全国代表性所有付款人数据用于比较与阿片类药物相关的主要诊断住院的死亡率和组成以及其他药物和所有其他原因住院的死亡率和组成。阿片类药物导致的住院死亡率从2000年前的0.43%上升到2014年的2.02%，相对于其他药物导致的住院死亡率，平均每年增加0.12个百分点。虽然阿片类药物导致的住院治疗总量保持相对稳定，但从主要涉及阿片类药物依赖或滥用的诊断转向以阿片类药物或海洛因中毒为中心的诊断（后者的病死率较高）。2000年以后，因类阿片/海洛因中毒住院的人数每年每千人增加0.01人，而因类阿片依赖或滥用住院的人数每年每千人减少0.01人。因阿片类药物/海洛因中毒入院的患者更可能是白色，年龄在50-64岁之间，医疗保险受益人有残疾，以及低收入地区的居民。随着美国打击阿片类药物流行病，需要努力帮助医院应对日益严重的阿片类药物中毒，特别是在弱势群体中。
Hospitals play an important role in caring for patients in the current opioid crisis, but data on the outcomes and composition of opioid-driven hospitalizations in the United States have been lacking. Nationally representative all-payer data for the period 1993-2014 from the National Inpatient Sample were used to compare the mortality rates and composition of hospitalizations with opioid-related primary diagnoses and those of hospitalizations for other drugs and for all other causes. Mortality among opioid-driven hospitalizations increased from 0.43 percent before 2000 to 2.02 percent in 2014, an average increase of 0.12 percentage points per year relative to the mortality of hospitalizations due to other drugs-which was unchanged. While the total volume of opioid-driven hospitalizations remained relatively stable, it shifted from diagnoses mostly involving opioid dependence or abuse to those centered on opioid or heroin poisoning (the latter have higher case fatality rates). After 2000, hospitalizations for opioid/heroin poisoning grew by 0.01 per 1,000 people per year, while hospitalizations for opioid dependence or abuse declined by 0.01 per 1,000 people per year. Patients admitted for opioid/heroin poisoning were more likely to be white, ages 50-64, Medicare beneficiaries with disabilities, and residents of lower-income areas. As the United States combats the opioid epidemic, efforts to help hospitals respond to the increasing severity of opioid intoxication are needed, especially in vulnerable populations.