Temporal trends in rates of opioid misuse among delivery-related hospitalizations in North Carolina from 2000 to 2014

Abstract

Opioid misuse during pregnancy is increasing at an alarming rate across the United States. To determine the prevalence, temporal trends, and resource usage of delivery-related hospitalizations of women who misuse opioids in North Carolina from 2000 to 2014. A retrospective, cross-sectional study was conducted using the State Inpatient Databases. Annual prevalence was calculated, and linear trends were assessed using logistic regression. Temporal trends in hospital charges and length of stay (LOS) were analyzed using ordinary least squares regression with a log_e-transformed response. Of 1,937,455 delivery-related hospitalizations in NC, 6,084 were associated with opioid misuse, a prevalence of 3.14 cases per 1,000 delivery-related discharges. During the study period, the prevalence of opioid misuse during pregnancy in NC increased 955%, from 0.9 cases per 1,000 discharges in 2000 to 9.5 cases per 1,000 discharges in 2014, an average annual rate increase of 1.18 cases (95% CI, 1.16–1.21; P < 0.0001). Median LOS for women who misuse opioids remained stable at three days, whereas the median charge per delivery-related hospitalization significantly increased from $6,311 in 2000 to $9,019 in 2010 (annual average change [AAC], 282.2; 95% CI, 182.9–381.5; P < 0.0001) and from $8,908 in 2011 to $10,864 in 2014 (AAC, 667.5; 95% CI, 275.2–1059.9; P < 0.0001). Health care providers and policymakers in NC are advised to introduce system-wide public health responses focused on prevention and increased access to evidence-based treatment that improves the health of the mothers and neonates who are exposed to opioids.

Keywords:

• Hospital charge
• length of stay
• opioid misuse
• pregnancy
• North Carolina
• State Inpatient Databases
• Healthcare Cost and Utilization Project
• Agency for Healthcare Research and Quality

Acknowledgments

The authors acknowledge Dr. Brian Byrd and Dr. Dolly Pressley-Byrd for their contributions to this manuscript.

Disclosure statement

The authors declare that they have no conflict of interests.

Data availability statement

The datasets used and/or analyzed during the current study are publicly available and can be accessed from HCUP (https://www.hcup-us.ahrq.gov).

Additional information

Funding

This study was supported by Western Carolina University Provost’s Internal Funding Support Grant (WCU-PIFSG) through the award SFA001-222955 (PI: B.T.A.).