Abstract
Introduction: As the opioid epidemic progresses, a better understanding of those at elevated risk of opioid overdose is needed, particularly for populations whose growing risk may be overlooked. Medicare recipients under age 65 (Medicare-disability beneficiaries [MDBs]) are one such population. We sought to analyze characteristics of opioid-overdose hospitalizations among MDBs and quantify the contribution of this population to opioid-overdose hospitalizations overall.
Methods: This retrospective cohort study included patients hospitalized for opioid overdose in the National/Nationwide Inpatient Sample from 1998 to 2013. The primary outcome measurements were number and characteristics of discharges, including patient sex, age, race, prescription opioid versus heroin overdose, and comorbidities.
Results: MDBs constituted 11.7% of US opioid overdose hospitalizations among those under 65 years of age in 1998; this proportion grew to 24.5% by 2013 (P < .0001). The proportion of female patients grew markedly among this cohort (P < .0001) and were disproportionately represented among MDBs (P < .0001). Prescription opioid overdose accounted for a larger proportion of opioid overdose hospitalizations among MDBs than among non-Medicare-insured patients under 65 years old (P < .0001). MDBs generally exhibited greater comorbidity burden versus non-Medicare-insured patients under age 65; however, chronic drug and alcohol abuse were less commonly documented among the Medicare cohort (P < .0001).
Conclusions: MDBs constitute a substantial and growing proportion of opioid overdose hospitalizations in the United. To prevent opioid overdoses among MDBs, care must be taken to address the unique needs of this population.
