scholarly journals The Financial Burden of Opioid-Related Abuse among Surgical and Non-Surgical Patients in Florida: A Longitudinal Study

2021 ◽  
Vol 18 (17) ◽  
pp. 9127
Author(s):  
Jing Xu ◽  
Nazik M. A. Zakari ◽  
Hanadi Y. Hamadi ◽  
Sinyoung Park ◽  
Donald Rob Haley ◽  
...  
Keyword(s):  
Longitudinal Study ◽  
Financial Burden ◽  
Opioid Abuse ◽  
Opioid Use ◽  
Retrospective Case ◽  
Discharge Data ◽  
Hospital Administrators ◽  
Icd 10 ◽  
Longitudinal Study Design ◽  
Insight Into

Florida is one of the eight states labeled as a high-burden opioid abuse state and is an epicenter for opioid use and misuse. The aim of our study was to measure multi-year total room charges and costs billed for opioid abuse-related events and to compare the costs of inpatient opioid abusers and non-opioid abusers for Florida hospitals from 2011 to 2017. We constructed a retrospective case-control longitudinal study design on inpatient administrative discharge data across 173 hospitals. Opioid abuse was defined using both ICD-9-CM and ICD-10-CM systems. We found a statistically significant association between opioid abuse diagnosis and total room charge. On average, opioid abuse status increased the room charges by 8.1%. We also noticed year-to-year variations in opioid abuse had a remarkable influence on hospital finances. We showed that since 2015, the differences significantly increased from 4–5% to 13–14% for both room charges and cost, which indicates the financial burden due to opioid abuse becoming more frequent. These findings are important to policymakers and hospital administrators because they provide crucial insight into Florida’s opioid crisis and its economic burden on hospitals.

Should Excess Topical Decongestant Use Raise a Red Flag? Rhinitis Medicamentosa and Opioid Use Disorder

2019 ◽  
Vol 129 (2) ◽  
pp. 164-169
Author(s):  
Aneesh Patel ◽  
Jessica R. Levi ◽  
Christopher D. Brook
Keyword(s):  
Medical Center ◽  
Academic Medical Center ◽  
Opioid Use Disorder ◽  
Opioid Abuse ◽  
Opioid Use ◽  
Retrospective Case ◽  
Chronic Rhinitis ◽  
Icd 10 ◽  
Red Flag ◽  
Rhinitis Medicamentosa

Objective: The objective of this study was to determine whether patients with rhinitis medicamentosa (RM) have an increased odds of having an opioid use disorder (OUD) and which characteristics may predict this association. Methods: The authors conducted a retrospective case control study of patients 18 years and older who presented to the otolaryngology clinic at an academic medical center from January 2013 through December 2017. Cases, defined as patients who presented with excessive decongestant nasal spray usage based on history, were matched to control patients who presented with chronic rhinitis and did not report regular nasal decongestant usage. The charts were reviewed for patients that carried a problem of opioid abuse, identified using ICD-9 codes 304.XX or ICD-10 codes F11.XX. The primary outcome of this study was the odds of having an OUD. Secondary outcomes were assessed by summary statistics. Results: One hundred and thirty-one cases of RM were matched to 1871 controls of chronic rhinitis. Seven cases (5.3%) and 24 (1.3%) controls had a diagnosis of OUD, consistent with an odds ratio of 3.98 for opioid abuse in patients with RM (95% CI: 1.47-9.71). Oxymetazoline was used by 85.5% (n = 112) of patients with RM. Thirty-six patients (27.1%) with RM underwent nasal surgery following a diagnosis of RM, of which twenty patients (55.6%) were prescribed opioids following the procedure. Conclusions: RM is associated with increased odds of having an OUD.

scholarly journals Hospitalized patients co-diagnosed with infective endocarditis and opioid drug dependence in Florida, 2015-2018

2021 ◽  
Vol 10 (4) ◽  
pp. 26
Author(s):  
Alexander Litvintchouk ◽  
Lori Bilello ◽  
Carmen Smotherman ◽  
Katryn Lukens Bull
Keyword(s):  
Infective Endocarditis ◽  
Financial Burden ◽  
The United States ◽  
Population Characteristics ◽  
Opioid Use ◽  
Discharge Disposition ◽  
Diagnosis Codes ◽  
Icd 10 ◽  
Using Data ◽  
Total Charges

Objective: As the opioid addiction epidemic continues to grow, other serious health issues regarding drug use has also increased. This study examines the trends in admissions and population characteristics of those who experience infective endocarditis with opioid drug dependence.Methods: We used ICD-9-CM and ICD-10-CM codes to identify patients admitted to a hospital with infective endocarditis and with a secondary diagnosis of opioid use related disorders using data released by the Florida Agency for Health Care Administration (AHCA). Data included age, gender, ethnicity, race, discharge disposition, admission type, payer status, total charges, and zip code of patients’ residence.Results: During the four-year period, the percent of patients diagnosed with infective endocarditis and a diagnosis code associated with opioid abuse or dependence doubled (4.48% to 8.52%). Of the patients dually diagnosed, the mean age was 37.47 and the majority were white (90.78%), non-Hispanic (91.96%), and female (58.55%). Nearly 47% of the patients did not have health insurance. The percentage of patients with both diagnosis codes living in urban counties was 91.37%. Median length of stay was 10 days and median total charges for patients was $101,604.Conclusions: With the increasing incidence of opioid dependence and addiction within the United States, there is a rise in infective endocarditis, a costly and debilitating disease. Our analysis provides the framework for hospital systems to identify patients who may benefit from addiction services, which through downstream effects will cause less of a health and financial burden.

scholarly journals Emergency Department Femoral Nerve Blocks and 1-Year Mortality in Fragility Hip Fractures

2019 ◽  
Vol 10 ◽  
pp. 215145931989389 ◽  
Author(s):  
Michael Darren Polischuk ◽  
Nrusheel Kattar ◽  
Ashwin Rajesh ◽  
Tony Gergis ◽  
Kieran King ◽  
...  
Keyword(s):  
Emergency Department ◽  
Hip Fractures ◽  
Femoral Nerve ◽  
Early Mobilization ◽  
Opioid Use ◽  
Retrospective Case ◽  
Nerve Blocks ◽  
Significant Difference ◽  
Insight Into ◽  
Control Study

Objective: Femoral nerve blocks (FNBs) for fragility hip fractures have benefits in improving pain relief and early mobilization while decreasing opioid use and rates of pneumonia. However, no study has looked at 1-year mortality outcomes for this intervention. This study aims to provide insight into 1-year outcomes. Methods: A single-site retrospective case–control study from 2007 to 2016 in primary fragility hip fractures compared 665 patients who received an emergency department FNB to 326 patients who did not receive an FNB. The primary outcome was 1-year mortality. Secondary outcomes included mortality, mobility, and residence at discharge, 6 months, and 1-year intervals. Results: There were no significant differences in preoperative characteristics. Although there was no statistically significant difference in 1-year mortality, patients who did not receive an FNB were more likely to be nonambulant at 1 year (odds ratio 1.71, 95% confidence interval, 1.14-2.57, P = .005). There were no other significant differences in mobility, residence, or mortality. Conclusion: There was no statistically significant difference in 1-year mortality, although individuals who did not receive an FNB were more likely to be nonambulant at 1 year.

The prevalence of pre-existing mental health, drug and alcohol conditions in major trauma patients

2017 ◽  
Vol 41 (3) ◽  
pp. 283 ◽  
Author(s):  
Tu Q. Nguyen ◽  
Pamela M. Simpson ◽  
Belinda J. Gabbe
Keyword(s):  
Mental Health ◽  
Medical Record ◽  
Major Trauma ◽  
Health Conditions ◽  
Trauma Patients ◽  
Discharge Data ◽  
Mental Health Conditions ◽  
Icd 10 ◽  
Record Review ◽  
Drug And Alcohol

Objective Capturing information about mental health, drug and alcohol conditions in injury datasets is important for improving understanding of injury risk and outcome. This study describes the prevalence of pre-existing mental health, drug and alcohol conditions in major trauma patients based on routine discharge data coding. Methods Data were extracted from the population-based Victorian State Trauma Registry (July 2005 to June 2013, n = 16 096). Results Seventeen percent of major trauma patients had at least one mental health condition compared with the Australian population prevalence of 21%. The prevalence of mental health conditions was similar to the Australian population prevalence in men (19% v. 18%), but lower in women (14% v. 25%) and across all age groups. Mental health conditions were more prevalent in intentional self-harm cases (56.3%) compared with unintentional (13.8%) or other intentional (31.2%) cases. Substance use disorders were more prevalent in major trauma patients than the general population (15% v. 5%), higher in men than women (17% v. 10%) and was highest in young people aged 25–34 years (24%). Conclusions Under-reporting of mental health conditions in hospital discharge data appears likely, reducing the capacity to characterise the injury population. Further validation is needed. What is known about the topic? Medical record review, routine hospital discharge data and self-report have been used by studies previously to characterise mental health, drug and alcohol conditions in injured populations, with medical record review considered the most accurate and reliance on self-report measures being considered at risk of recall bias. The use of routinely collected data sources provides an efficient and standardised method of characterising pre-existing conditions, but may underestimate the true prevalence of conditions. What does this paper add? No study to date has explored the prevalence of Abbreviated Injury Scale and International Classification of Diseases and Health Related Problems, Tenth Revision, Australian Modification (ICD-10-a.m)-coded mental health, alcohol and drug conditions in seriously injured populations. The results of this study show the incidence of mental health conditions appeared to be under-reported in major trauma patients, suggesting limitations in the use of ICD-10-a.m. to measure mental health comorbidities. What are the implications for practitioners? In order to achieve improvements in measuring mental health, drug and alcohol comorbidities, we suggest the use of a series of different diagnostic systems to be used in conjunction with ICD-10-a.m., such as medical record review and self-reporting as well as linkage to other datasets. When applied simultaneously, diagnosis and outcomes of mental health may be compared and validated across diagnostic systems and deviations in diagnoses could be more readily accounted for.

scholarly journals Descriptive exploration of overdose codes in hospital and emergency department discharge data to inform development of drug overdose morbidity surveillance indicator definitions in ICD-10-CM

2021 ◽  
Vol 27 (S1) ◽  
pp. i27-i34
Author(s):  
Leigh M Tyndall Snow ◽  
Katelyn E Hall ◽  
Cody Custis ◽  
Allison L Rosenthal ◽  
Emilia Pasalic ◽  
...  
Keyword(s):  
Emergency Department ◽  
Adverse Effects ◽  
Drug Overdose ◽  
International Classification Of Diseases ◽  
Primary Diagnosis ◽  
Epidemiological Surveillance ◽  
Discharge Data ◽  
Aggregated Data ◽  
Data Coding ◽  
Icd 10

BackgroundIn October 2015, discharge data coding in the USA shifted to the International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM), necessitating new indicator definitions for drug overdose morbidity. Amid the drug overdose crisis, characterising discharge records that have ICD-10-CM drug overdose codes can inform the development of standardised drug overdose morbidity indicator definitions for epidemiological surveillance.MethodsEight states submitted aggregated data involving hospital and emergency department (ED) discharge records with ICD-10-CM codes starting with T36–T50, for visits occurring from October 2015 to December 2016. Frequencies were calculated for (1) the position within the diagnosis billing fields where the drug overdose code occurred; (2) primary diagnosis code grouped by ICD-10-CM chapter; (3) encounter types; and (4) intents, underdosing and adverse effects.ResultsAmong all records with a drug overdose code, the primary diagnosis field captured 70.6% of hospitalisations (median=69.5%, range=66.2%–76.8%) and 79.9% of ED visits (median=80.7%; range=69.8%–88.0%) on average across participating states. The most frequent primary diagnosis chapters included injury and mental disorder chapters. Among visits with codes for drug overdose initial encounters, subsequent encounters and sequelae, on average 94.6% of hospitalisation records (median=98.3%; range=68.8%–98.8%) and 95.5% of ED records (median=99.5%; range=79.2%–99.8%), represented initial encounters. Among records with drug overdose of any intent, adverse effect and underdosing codes, adverse effects comprised an average of 74.9% of hospitalisation records (median=76.3%; range=57.6%–81.1%) and 50.8% of ED records (median=48.9%; range=42.3%–66.8%), while unintentional intent comprised an average of 11.1% of hospitalisation records (median=11.0%; range=8.3%–14.5%) and 28.2% of ED records (median=25.6%; range=20.8%–40.7%).ConclusionResults highlight considerations for adapting and standardising drug overdose indicator definitions in ICD-10-CM.

The Sport Marriage

2020 ◽  
Author(s):  
Steven M. Ortiz
Keyword(s):  
Longitudinal Study ◽  
Professional Sports ◽  
Public And Private ◽  
Great Cost ◽  
Women's Voices ◽  
Private Lives ◽  
Power And Control ◽  
Sport Industry ◽  
And Control ◽  
Insight Into

Male professional athletes captivate fans and profoundly influence today’s society as part of the $1.3 trillion global sport industry. Although these athletes’ lives and careers are widely reported, scholarly knowledge about the women who support them—their wives—is extremely limited. Because these women’s voices have historically been stifled, their marriages are shockingly misunderstood. Based on findings from the first and only longitudinal study on the sport marriage, this book corrects the abundance of misinformation reported by all forms of media, dispels undeserved stereotypes, and addresses inaccurate assumptions about the heteronormative sport marriage. It demonstrates how, despite major changes in society and sport since the end of the last century, the fundamental nature of the heteronormative sport marriage has not changed. Sport wives remain isolated and subordinate, even while they make significant contributions to their husbands’ careers. Identifying the sport marriage as a career-dominated marriage, the book allows us into these women’s public and private lives, including their need to conform to unwritten rules and codes, adapt to abundant power and control issues, cope with groupies from all walks of life, and find ways to deal with their oft-justified fears about their husbands’ infidelity. The book shares intimate stories about, and provides rare and unflinching insight into, what it is like to be married to these highly visible men, what it means to be a woman in the male-dominated world of professional sports, and why women remain in a sport marriage at great cost to themselves.

scholarly journals The pitch of babies’ cries predicts their voice pitch at age 5

2018 ◽  
Vol 14 (7) ◽  
pp. 20180065 ◽  
Author(s):  
Florence Levrero ◽  
Nicolas Mathevon ◽  
Katarzyna Pisanski ◽  
Erik Gustafsson ◽  
David Reby
Keyword(s):  
Longitudinal Study ◽  
Individual Differences ◽  
Fundamental Frequency ◽  
Ring Finger ◽  
Small Sample ◽  
Voice Pitch ◽  
Same Sex ◽  
Before And After ◽  
Longitudinal Study Design ◽  
The Right

Voice pitch (fundamental frequency, F 0 ) is a key dimension of our voice that varies between sexes after puberty, and also among individuals of the same sex both before and after puberty. While a recent longitudinal study indicates that inter-individual differences in voice pitch remain stable in men during adulthood and may even be determined before puberty (Fouquet et al. 2016 R. Soc. open sci. 3 , 160395. ( doi:10.1098/rsos.160395 )), whether these differences emerge in infancy remains unknown. Here, using a longitudinal study design, we investigate the hypothesis that inter-individual differences in F 0 are already present in the cries of pre-verbal babies. While based on a small sample ( n = 15), our results indicate that the F 0 of babies' cries at 4 months of age may predict the F 0 of their speech utterances at 5 years of age, explaining 41% of the inter-individual variance in voice pitch at that age in our sample. We also found that the right-hand ratio of the length of their index to ring finger (2D : 4D digit ratio), which has been proposed to constitute an index of prenatal testosterone exposure, was positively correlated with F 0 at both 4 months and 5 years of age. These findings suggest that a substantial proportion of between-individual differences in voice pitch, which convey important biosocial information about speakers, may partly originate in utero and thus already be present soon after birth.

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