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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 15 of 15 Research Studies DisplayedKeenan KE, Rothberg MB, Herzig SJ
Association between opioids prescribed to medical inpatients with pain and long-term opioid use.
This study’s objective was to identify the association between opioid exposure during a medical hospitalization and opioid use 6 to 12 months later. This observational cohort study used electronic health record data from 10 hospitals in the Cleveland Clinic Health System in 2016. Eligible patients were opioid-naïve adults with pain 18 years and older. The authors estimated the odds of long-term opioid use (defined as ≥2 prescriptions for at least 30 pills 6 to 12 months posthospitalization) by opioid exposure during the hospitalization. Among the 2971 patients in the study, 64% received opioids during their hospitalization, and 28% were discharged with opioids. A total of 3% of patients had long-term use with a higher pain score associated with greater odds of long-term use.
AHRQ-funded; HS026215.
Citation: Keenan KE, Rothberg MB, Herzig SJ .
Association between opioids prescribed to medical inpatients with pain and long-term opioid use.
South Med J 2021 Oct;114(10):623-29. doi: 10.14423/smj.0000000000001307..
Keywords: Opioids, Hospitalization, Pain, Substance Abuse, Medication
Zubiago J, Murphy M, Guardado R
Increased HIV testing in people who use drugs hospitalized in the first wave of the COVID-19 pandemic.
During the COVID-19 pandemic, due to lapses in harm reduction services, several public health experts forecasted subsequent increases in diagnosis of HIV in PWUD. As many inpatient hospitals reworked patient flow during the COVID-19 surge, the investigators hypothesized that HIV testing in PWUD would decrease. To answer this question, they compiled a deidentified list of hospitalized patients with electronic medical record indicators of substance use-a positive urine toxicology screen, prescribed medications to treat opioid use disorder, a positive CIWA score, or a positive CAGE score-admitted between January, 2020 and August, 2020.
AHRQ-funded; HS026008.
Citation: Zubiago J, Murphy M, Guardado R .
Increased HIV testing in people who use drugs hospitalized in the first wave of the COVID-19 pandemic.
J Subst Abuse Treat 2021 May;124:108266. doi: 10.1016/j.jsat.2020.108266..
Keywords: Human Immunodeficiency Virus (HIV), Opioids, Substance Abuse, Alcohol Use, Hospitalization, COVID-19, Public Health, Screening
Baillargeon J, Polychronopoulou E, Kuo YF
The impact of substance use disorder on COVID-19 outcomes.
The goal of this study was to examine the impact of substance use disorder on the risk of hospitalization, complications, and mortality among adult patients diagnosed as having COVID-19. Using data from the TriNetX Research Network database, primary analysis showed that substance use disorder was associated with an increased risk of hospitalization, ventilator use, and mortality. These findings suggest that COVID-19 patients with substance use disorders are at increased risk for adverse outcomes.
AHRQ-funded; HS026133.
Citation: Baillargeon J, Polychronopoulou E, Kuo YF .
The impact of substance use disorder on COVID-19 outcomes.
Psychiatr Serv 2021 May;72(5):578-81. doi: 10.1176/appi.ps.202000534..
Keywords: COVID-19, Substance Abuse, Hospitalization, Mortality, Risk
Afshar M, Sharma B, Bhalla S
External validation of an opioid misuse machine learning classifier in hospitalized adult patients.
This study looks at new methods to make opioid misuse screening in hospitals less resource-intensive, which causes it to occur rarely. The objective of this study is to externally validate the author’s previously published and open-source machine learning classifier by implementing it a different hospital to identify cases of opioid misuse. An observational cohort of 56,227 adult hospitalizations from October 2017 to December 2019 was used during a hospital-wide substance use screening program with manual screening. A manually completed Drug Abuse Screening Test served as the reference standard to validate a convolutional neural network (CNN) classified with coded word embedding features to capture electronic health record (EHR) clinical notes. Manual screening was completed in 67.8% of patients with 1.1% identified with opioid misuse. The opioid misuse classifier had good discrimination during external validation and may help overcome manual screening barriers.
AHRQ-funded; HS026385.
Citation: Afshar M, Sharma B, Bhalla S .
External validation of an opioid misuse machine learning classifier in hospitalized adult patients.
Addict Sci Clin Pract 2021 Mar 17;16(1):19. doi: 10.1186/s13722-021-00229-7..
Keywords: Opioids, Medication, Substance Abuse, Screening, Hospitalization
Rapoport AB, Fine DR, Manne-Goehler JM
High inpatient health care utilization and charges associated with injection drug use-related infections: a cohort study, 2012-2015.
This study described the characteristics of patients hospitalized with injection drug use-related infection over a multiyear period in a region highly impacted by the opioid epidemic. Findings revealed a longer average length of stay with subsequent higher cost, a higher percentage of 30-day readmissions, disproportionate public payer mix representation, and higher rates of discharge to alternate facilities for ongoing care as compared with the total inpatient cohort.
AHRQ-funded; HS026215.
Citation: Rapoport AB, Fine DR, Manne-Goehler JM .
High inpatient health care utilization and charges associated with injection drug use-related infections: a cohort study, 2012-2015.
Open Forum Infect Dis 2021 Mar;8(3):ofab009. doi: 10.1093/ofid/ofab009..
Keywords: Opioids, Substance Abuse, Hospitalization, Healthcare Costs, Healthcare Utilization
Hirai AH, Ko JY, Owens PL
AHRQ Author: Owens PL, Stocks C
Neonatal abstinence syndrome and maternal opioid-Related diagnoses in the US, 2010-2017.
This study analyzed trends in neonatal abstinence syndrome (NAS) and maternal opioid-Related diagnosis (MOD) in the United States from 2010 to 2017. A cross-sectional analysis was done of the HCUP National Inpatient Sample and State Inpatient Database from 2010 through 2017. Diagnoses of NAS and MOD were found using the ICD-10, CM codes. Significant increases occurred in rates of NAS, from 4.0 to 7.3 per birth hospitalizations and MOD, from 3.5 to 8.2 per 1000 delivery hospitalizations. A census of 47 state databases in 2017 found a large range of NAS rates – from 1.3 per 1000 birth hospitalizations in Nebraska to 53.5 per 1000 hospitalizations in West Virginia with the same ranges found for MOD rates. In all states except Nebraska and Vermont which only had significant MOD increases, NAS and MOD rates rose significantly from 2010 to 2017.
AHRQ-authored; AHRQ-funded; 290201800001C.
Citation: Hirai AH, Ko JY, Owens PL .
Neonatal abstinence syndrome and maternal opioid-Related diagnoses in the US, 2010-2017.
Neonatal abstinence syndrome and maternal opioid-Related diagnoses in the US, 2010-2017..
Keywords: Healthcare Cost and Utilization Project (HCUP), Newborns/Infants, Opioids, Medication, Substance Abuse, Hospitalization, Pregnancy
Thompson HM, Faig W, VanKim NA HM, Faig W, VanKim NA
Differences in length of stay and discharge destination among patients with substance use disorders: The effect of Substance Use Intervention Team (SUIT) consultation service.
Addiction medicine consultation services (ACS) may improve outcomes of hospitalized patients with substance use disorders (SUD). The aim of the study was to examine the difference in length of stay and the hazard ratio for a routine hospital discharge between SUD patients receiving and not receiving ACS. The authors concluded that the Substance Use Intervention Team (SUIT) consultation service was associated with a reduced length of stay and an increased hazard of a routine discharge.
AHRQ-funded; HS026385.
Citation: Thompson HM, Faig W, VanKim NA HM, Faig W, VanKim NA .
Differences in length of stay and discharge destination among patients with substance use disorders: The effect of Substance Use Intervention Team (SUIT) consultation service.
PLoS One 2020 Oct 9;15(10):e0239761. doi: 10.1371/journal.pone.0239761..
Keywords: Substance Abuse, Hospitalization, Inpatient Care, Hospital Discharge, Hospitals
Kim JH, Fine DR, Li L
Disparities in United States hospitalizations for serious infections in patients with and without opioid use disorder: a nationwide observational study.
This study examined the differences in patients with and without opioid use disorder (OUD) who were hospitalized for serious infections focusing on infective endocarditis, epidural abscess, septic arthritis or osteomyelitis. The authors used the 2016 National Inpatient Sample to examine differences in length of stay (LOS), discharge disposition, and charges. Patients with OUD had a lower probability of discharge at any given LOS, and lower odds of discharge to home with higher odds of discharge to a post-acute care facility. There were no significant differences in average total hospital charges.
AHRQ-funded; HS026215.
Citation: Kim JH, Fine DR, Li L .
Disparities in United States hospitalizations for serious infections in patients with and without opioid use disorder: a nationwide observational study.
PLoS Med 2020 Aug;17(8):e1003247. doi: 10.1371/ournal.pmed.1003247.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Disparities, Opioids, Substance Abuse, Hospitalization, Medication, Infectious Diseases
Rowell-Cunsolo TL, Liu J, Hu G
Length of hospitalization and hospital readmissions among patients with substance use disorders in New York City, NY USA.
In the United States, the number of patients with substance use disorders is steadily increasing. Individuals with a substance use disorder may be more likely to experience negative hospital outcomes, including lengthier hospital stays and frequent readmissions, which is extremely costly to patients and to the government. In this study, the investigators assessed whether hospital admissions diagnosed with substance use disorders experienced longer hospital stays and readmissions compared to patients without a substance use disorder diagnosis.
AHRQ-funded; HS024915.
Citation: Rowell-Cunsolo TL, Liu J, Hu G .
Length of hospitalization and hospital readmissions among patients with substance use disorders in New York City, NY USA.
Drug Alcohol Depend 2020 Jul 1;212:107987. doi: 10.1016/j.drugalcdep.2020.107987..
Keywords: Substance Abuse, Hospitalization, Hospital Readmissions
Gupta NM, Lindenauer PK, Yu PC
Association between alcohol use disorders and outcomes of patients hospitalized with community-acquired pneumonia.
The purpose of this study was to compare the causes, treatment, and outcomes of pneumonia in patients with and without alcohol use disorder (AUD). Results suggest that, compared with hospitalized patients with community-acquired pneumonia but without AUD, those with AUD less often harbor resistant organisms. The authors conclude that higher age-adjusted risk of death among patients with AUD appears to be largely attributable to differences in comorbidities, whereas greater use of health care resources may be attributable to alcohol withdrawal.
AHRQ-funded; HS024277; HS025026.
Citation: Gupta NM, Lindenauer PK, Yu PC .
Association between alcohol use disorders and outcomes of patients hospitalized with community-acquired pneumonia.
JAMA Netw Open 2019 Jun 5;2(6):e195172. doi: 10.1001/jamanetworkopen.2019.5172..
Keywords: Alcohol Use, Community-Acquired Infections, Hospitalization, Outcomes, Pneumonia, Substance Abuse
Blanchard J, Weiss AJ, Barrett ML
AHRQ Author: Stocks C, Owens PL, Heslin KC
Readmissions following inpatient treatment for opioid-related conditions.
This study analyzed the relationship between hospital admission for inpatient drug detoxification and/or rehabilitation services and subsequent opioid-related readmission. The study used hospital inpatient discharge and emergency department visit data from the AHRQ Healthcare Cost and Utilization Project (HCUP) survey. The sample consisted of 329,037 patients from seven states with an opioid-related index hospitalization from March 2010 to September 2013. A relatively small percentage (19.4%) of patients received treatment for drug use during their hospital stay. Those patients that did receive treatment had a lower 90-day readmission rate than those patients who did not.
AHRQ-authored; AHRQ-funded.
Citation: Blanchard J, Weiss AJ, Barrett ML .
Readmissions following inpatient treatment for opioid-related conditions.
Subst Use Misuse 2019;54(3):473-81. doi: 10.1080/10826084.2018.1517174..
Keywords: Healthcare Cost and Utilization Project (HCUP), Opioids, Hospital Readmissions, Hospitalization, Inpatient Care, Substance Abuse, Medication
Heslin KC, Owens PL, Karaca Z
AHRQ Author: Heslin KC; Owens PL; Karaca Z; Elixhauser A
Trends in opioid-related inpatient stays shifted after the US transitioned to ICD-10-CM diagnosis coding in 2015.
This study examines how trend analyses of inpatient stays involving opioid diagnoses were affected by the transition to ICD-10-CM. It found a sharp increase in opioid-related stays overall during the transition to ICD-10-CM. This may indicate that the new classification system is capturing stays that were missed by ICD-9-CM data.
AHRQ-authored.
Citation: Heslin KC, Owens PL, Karaca Z .
Trends in opioid-related inpatient stays shifted after the US transitioned to ICD-10-CM diagnosis coding in 2015.
Med Care 2017 Nov;55(11):918-23. doi: 10.1097/mlr.0000000000000805.
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Keywords: Critical Care, Healthcare Cost and Utilization Project (HCUP), Hospitalization, Opioids, Substance Abuse
Chhatre S, Cook R, Mallik E
Trends in substance use admissions among older adults.
Researchers sought to analyze the trends in admissions for substance abuse treatment among older adults (aged 55 and older). Substantial changes in the demographic, substance use pattern, and treatment characteristics for the older adult admissions were noted. The proportion of admissions for following primary substances showed increase: cocaine/crack, marijuana/hashish, heroin, non-prescription methadone, and other opiates and synthetics.
AHRQ-funded; HS024106.
Citation: Chhatre S, Cook R, Mallik E .
Trends in substance use admissions among older adults.
BMC Health Serv Res 2017 Aug 22;17(1):584. doi: 10.1186/s12913-017-2538-z.
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Keywords: Behavioral Health, Elderly, Hospitalization, Opioids, Substance Abuse
Kim HS, Monte AA
Colorado cannabis legalization and its effect on emergency care.
The authors noted that increased marijuana use after legalization has been accompanied by increases in emergency department visits and hospitalizations due to marijuana intoxication. They recommended that providers in states with impending legalization measures should become familiar with the symptoms and management of acute marijuana intoxication, as well as understand the effects on chronic diseases frequently observed in the emergency department. Further, they suggested that residency program directors should make an effort to integrate this topic into their residency curricula.
AHRQ-funded; HS000078.
Citation: Kim HS, Monte AA .
Colorado cannabis legalization and its effect on emergency care.
Ann Emerg Med 2016 Jul;68(1):71-5. doi: 10.1016/j.annemergmed.2016.01.004.
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Keywords: Emergency Department, Emergency Medical Services (EMS), Hospitalization, Policy, Substance Abuse
Binswanger IA, Whitley E, Haffey PR
A patient navigation intervention for drug-involved former prison inmates.
The researchers designed a randomized controlled trial of patient navigation to reduce barriers to health care and hospitalizations for former prison inmates. They found recruitment of former inmates highly feasible, but found that follow-up was limited by rearrests. They concluded that their results suggest a significantly lower rate of hospitalizations among navigation participants, although the rate of emergency department/urgent care visits was not improved.
AHRQ-funded; HS019464.
Citation: Binswanger IA, Whitley E, Haffey PR .
A patient navigation intervention for drug-involved former prison inmates.
Subst Abus 2015;36(1):34-41. doi: 10.1080/08897077.2014.932320.
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Keywords: Access to Care, Emergency Medical Services (EMS), Healthcare Utilization, Hospitalization, Substance Abuse