Characteristics of Patients, Providers, and Clinics by Receipt of Opioid and Non-opioid Pain Medication Prescriptions within 90 Days After Index Image*
| All Patients n (%)† N = 238,886 | Received Immediate Opioid Prescription n (%)‡ N = 70,195 (29) | Received Immediate Non-opioid Prescription n (%)‡ N = 84,063 (35) | |
|---|---|---|---|
| Patient-Level Characteristics | |||
| Age group (years) | |||
| 18 to 39 | 43,342 (18) | 9,679 (22) | 15,695 (36) |
| 40 to 60 | 90,027 (38) | 26,128 (29) | 35,143 (39) |
| >60 | 105,517 (44) | 34,388 (33) | 33,225 (31) |
| Sex | |||
| Male | 101,499 (42) | 28,956 (29) | 33,365 (33) |
| Female | 137,387 (58) | 41,239 (30) | 50,498 (37) |
| Modality for index image | |||
| Radiograph | 192,435 (81) | 55,466 (29) | 70,234 (37) |
| Computed tomography | 943 (0.4) | 412 (44) | 288 (31) |
| Magnetic resonance imaging | 45,508 (19) | 14,317 (31) | 13,541 (30) |
| Race | |||
| Asian | 26,508 (11) | 4,062 (15) | 7,162 (27) |
| Black/African American | 23,642 (10) | 7,678 (33) | 8,416 (36) |
| Native Hawaiian/Pacific Islanders | 1,614 (0.7) | 389 (24) | 583 (36) |
| Native American/Alaska Native | 1,686 (0.7) | 610 (36) | 708 (42) |
| Multiracial | 1,005 (0.4) | 296 (29) | 376 (37) |
| White | 184,431 (77) | 57,728 (31) | 66,818 (36) |
| Ethnicity | |||
| Hispanic | 36,229 (15) | 9,342 (26) | 13,702 (38) |
| Not Hispanic | 202,657 (85) | 60,853 (30) | 70,361 (35) |
| Socioeconomic status quartile | |||
| 1st | 15,824 (7) | 5,446 (34) | 6,333 (40) |
| 2nd | 31,213 (13) | 10,574 (34) | 12,215 (39) |
| 3rd | 57,564 (24) | 18,808 (33) | 21,879 (38) |
| 4th | 134,285 (56) | 35,367 (26) | 43,636 (33) |
| Insurance status | |||
| Medicare | 90,841 (38) | 31,951 (35) | 29,103 (32) |
| Medicaid/state-subsidized | 12,056 (5) | 4,230 (35) | 5,388 (45) |
| Commercial (including Medicare supplements) | 131,743 (55) | 32,693 (25) | 47,911 (36) |
| Veterans Administration | 248 (0.1) | 60 (24) | 84 (34) |
| Self-pay | 1,301 (0.5) | 490 (38) | 596 (46) |
| Unknown/missing | 2,697 (1) | 771 (29) | 981 (36) |
| Charlson comorbidity index | |||
| 0 | 153,079 (64) | 38,227 (25) | 53,108 (35) |
| 1 | 41,868 (18) | 14,449 (35) | 15,868 (38) |
| 2 | 23,211 (10) | 8,214 (35) | 7,828 (34) |
| 3+ | 20,728 (9) | 9,305 (45) | 7,259 (35) |
| Prescription for opioid in 120 days before index: | |||
| Yes | 61,531 (26) | 38,581 (63) | 35,397 (52) |
| No | 177,355 (74) | 31,614 (18) | 48,666 (29) |
| Image finding status | |||
| None | 55,546 (23) | 13,327 (24) | 20,627 (37) |
| Clinically unimportant finding | 149,192 (62) | 45,558 (31) | 53,206 (36) |
| Clinically important finding | 34,148 (14) | 11,310 (33) | 10,230 (30) |
| Time of index image | |||
| Oct 2013 to Mar 2014 | 48,233 (20) | 16,087 (33) | 16,909 (35) |
| Apr 2014 to Sept 2014 | 30,529 (13) | 9,952 (33) | 10,833 (35) |
| Oct 2014 to Mar 2015 | 39,424 (17) | 11,730 (30) | 14,204 (36) |
| Apr 2015 to Sept 2015 | 41,796 (18) | 11,959 (29) | 14,816 (35) |
| Oct 2015 to Mar 2016 | 39,177 (16) | 10,526 (27) | 13,726 (35) |
| Apr 2016 to Sept 2016 | 39,727 (17) | 9,941 (25) | 13,575 (34) |
| Image Ordering Provider-Level Characteristics | |||
| Provider mean age (IQR) | 49.3 (43 to 55) | 49.6 (43 to 56) | 49.0 (43 to 55) |
| Provider type | |||
| Doctor Osteopathy | 17,288 (7) | 5,167 (30) | 6,542 (38) |
| Medical Doctor | 213,524 (89) | 62,250 (29) | 74,170 (35) |
| Physician Assistant/Nurse Practitioner | 8,074 (3) | 2,778 (34) | 3,351 (42) |
| Provider sex | |||
| Female | 125,520 (53) | 35,315 (28) | 44,206 (35) |
| Male | 113,366 (47) | 34,880 (31) | 39,857 (35) |
| Provider specialty | |||
| Family medicine | 117,072 (49) | 36,042 (31) | 44,100 (38) |
| Internal medicine | 119,842 (50) | 33,602 (28) | 39,278 (33) |
| Other | 1972 (0.8) | 551 (28) | 685 (35) |
| Imaging Clinic-Level Characteristics | |||
| Rural-urban commuting area type | |||
| Urban | 231,352 (97) | 67,391 (29) | 81,184 (35) |
| Large rural | 4,106 (1.7) | 1,436 (35) | 1,569 (38) |
| Small rural | 3,043 (1.3) | 1,247 (41) | 1,215 (40) |
| Isolated small rural | 385 (0.2) | 121 (31) | 95 (25) |
| Clinic size | |||
| Small | 48,053 (20) | 14,044 (29) | 15,725 (33) |
| Medium | 74,035 (31) | 22,315 (30) | 25,014 (34) |
| Large | 116,798 (49) | 33,836 (29) | 43,324 (37) |
IQR, Interquartile range.
↵* Note that 36,119 patients (15% of the total) received prescriptions for both opioid and non-opioid pain medications within 90 days and are therefore represented in multiple columns; similarly, n = 120,747 received neither immediate opioid nor non-opioid pain prescriptions.
↵† Percentages presented in columns.
↵‡ Percentages presented in rows.