Abstract
Introduction
Our state’s Strengthen Opioid Misuse Prevention (“STOP”) Act was enacted on January 1 st 2018 to reduce prescription opioid misuse. We sought to evaluate the impact of opioid-limiting legislation on readmission rates among burn patients to our tertiary care burn center related to uncontrolled pain.
Methods
Patients were identified using an institutional Burn Center registry and linked to clinical and administrative data. All patients admitted between July 1 st, 2014 to June 20 th, 2019 were eligible for inclusion. Injury mechanism categories and reasons for readmissions were evaluated. Statistical analysis was carried out using chi-squared test and significance was accepted as p< 0.05.
Results
Of the 7872 total admissions, 160 (2%) were readmissions. Mean number of readmissions for every year was 32. There was an increase in number of readmissions in 2018 observed but it was not statistically significant (2014 n=12, 2015 n=35, 2016 n=21, 2017 n=33, 2018 n=40, 2019 n=19). The reasons for readmission included wound progression, graft failure, infection, and pain. There was an increase in readmissions for infection, wound progression and graft failure after January 2018, p< 0.05. The percentage of patients readmitted for pain increased between 2014 to 2019 but it was not statistically significant.
Conclusions
The primary reasons for readmissions to our burn center were pain, infection, graft failure, and progression of disease. Despite the opioid-limiting law there was not an increase in readmissions related to pain.
Applicability of Research to Practice
This study demonstrates that our current discharge planning strategies are managing pain expectations for patients. Our focus should be shifted towards improving infection control and wound care.
Examining Rural/Urban Differences in Prescription Opioid Misuse Among US Adolescents