AHRQ Views: Blog posts from AHRQ leaders
Digging Into County-Level Hospital Statistics To Understand the Impact of Opioids
As I've written in other blog posts, we live in a digital age that puts a premium on the availability and use of data to make the best decisions possible about health care and the services patients receive. That includes identifying innovative ways to defeat the Nation's opioid epidemic. In order for States and local communities to better understand the problem, however, more data must be made available to policymakers, researchers, and public health officials.
That's why as Director of AHRQ, I'm excited about the efforts we have underway to achieve that goal and the unique contributions we can make in reducing Americans' dependence on opioids and other substances. In particular, the Agency took an important step forward recently when we posted our first-ever Community-Level Statistics on Hospitalization Rates Related to Substance Use.
The new resource provides substance use-related hospitalization rates in 2014 for opioids, alcohol, stimulants, and other drugs and conditions drawn from more than 1,600 counties and two cities in 32 States. The tool, which is part of our Healthcare Cost and Utilization Project (HCUP), is one of several AHRQ data resources that help track national trends in health care. And, as highlighted in a recent press release, we've updated our interactive map for opioid-related hospitalizations.
With this new resource at their fingertips, public health officials, clinicians, first responders, researchers and others have a ground-breaking tool to help define and tackle the most pressing local health challenges.
As the statistics illustrate, the impacts and challenges of substance misuse vary widely between communities. While hospitalization rates in one county may suggest that alcohol persists as the most urgent substance-related problem, rates in a neighboring county may show an alarming rate in opioid-related hospitalizations.
Here are some examples that illustrate variations between communities, large and small.
Los Angeles County's opioid-related hospitalization rate in 2014 was 134 hospital stays per 100,000 people—lower than the national average of 218 per 100,000. Yet, that county's rate for cannabis misuse was higher: 174 stays per 100,000 people. Even higher was its rate for stimulant misuse, such as cocaine and methamphetamines: 211 per 100,000. While all of these numbers are too high, it may be instructive to Los Angeles County health officials to quantify the comparatively high burden of stimulant misuse on local hospitals.
More than 1,600 miles away near the border of Mexico, the picture in Starr County, Texas, is considerably different. In 2014, 296 hospitalizations per 100,000 people were attributed to substance misuse. Of those, only 11 were for opioids. Among the 1,600-plus U.S. counties included in Community-Level Statistics, Starr County's opioid-related hospitalization rate ranked lowest among all counties—17 hospital stays per 100,000 people. Local officials may find it helpful to know that all other forms of drug misuse had a higher discharge rate than the rate for opioids.
Clearly, a one-size-fits-all approach to tackling substance misuse is not ideal. That said, it's important to remember one persistent national truth: alcohol misuse is still the number one factor in the nation for substance use hospitalizations. In Los Angeles County, for example, the alcohol-related hospitalization rate in 2014 was 534 stays per 100,000 people—nearly equivalent to the rate for opioids, stimulants, and cannabis combined. Across the U.S., alcohol affects more people, more families, and more communities than any of these other substances.
For those eager to dig deeper into AHRQ's resource on county-level statistics, the possibilities are numerous. Users can search by age group, sex, payer, and type of stay. Downloadable tables, graphs, and maps are available for users to compare counties within a specific State, as well as with counties in other States.
As previously mentioned, HCUP is just one of our data resources that can assist policymakers and researchers in finding solutions to stopping the opioid epidemic. AHRQ's Fast Stats is an online tool that allows users to analyze State-by-State HCUP information on hospital use, including opioid-related hospitalizations.
Another excellent data resource to support policymakers' efforts to develop cost-effective health care strategies is our Medical Expenditure Panel Survey (MEPS). MEPS provides a set of large-scale surveys on health care for families and individuals, their medical providers, and employer insurance across the country, and is the most complete source of data on the cost and use of health care and health insurance coverage.
We will continue to update these resources, including our county-level statistics, as more data become available. The development, analysis, and dissemination of data are central to AHRQ's mission in a digital age, and we’re excited to fulfill that role in support of ongoing national efforts to protect and improve the health of all Americans.
Gopal Khanna is the Director of AHRQ.