Format

Send to

Choose Destination
J Clin Anesth. 2019 May;54:66-71. doi: 10.1016/j.jclinane.2018.10.036. Epub 2018 Nov 5.

Cardiorespiratory morbidity and mortality of opioid overdose during admission to safety-net hospitals.

Author information

1
School of Medicine, University of California, San Diego, San Diego, CA, USA.
2
Department of Anesthesiology, University of California, San Diego, San Diego, CA, USA.
3
Department of Anesthesiology, University of California, San Diego, San Diego, CA, USA; Department of Medicine, Division of Biomedical Informatics, University of California, San Diego, San Diego, CA, USA. Electronic address: ragabriel@ucsd.edu.

Abstract

STUDY OBJECTIVE:

Safety-net hospitals disproportionately care for high-risk patients. Prior work has shown safety-net hospitals to have inferior postoperative outcomes with higher cost and worse patient ratings. We aim to examine the association of hospital safety-net burden with morbidity and mortality in patients with opioid overdose hospital admission.

DESIGN:

Retrospective cross-sectional analysis using the National Inpatient Sample registry from 2010 to 2014.

SETTING:

Multi-institutional.

PATIENTS:

We included 547, 399 patients admitted to a United States hospital with an International Classification of Disease, Ninth Revision, code of opioid overdose. To study the association of hospital safety-net burden on mortality and morbidity, we calculated hospital safety-net burden defined as the percent of Medicaid or uninsured among all admitted patients. Hospitals were categorized into one of three categories: low burden hospitals, medium burden hospitals, and high burden hospitals (i.e., safety-net hospitals). We performed a mixed effects multivariable logistic regression analysis to assess the association of hospital safety-net burden with short-term inpatient outcomes.

INTERVENTION:

None.

MEASUREMENTS:

The primary outcomes were inpatient mortality and morbidity.

MAIN RESULTS:

Compared to MBHs and LBHs, HBHs had a greater proportion of minority patients (i.e., Black, Hispanic, and Native American) and patients with median household income in the lowest quartile (p < 0.001). Among prescription opioid overdose admissions, the odds of inpatient mortality and pulmonary and cardiac morbidity were also not significantly higher between HBHs versus LBHs (p > 0.05).

CONCLUSIONS:

Safety-net hospital disproportionately care for vulnerable populations, however the odds of poor outcomes were no different in opioid overdose. Safety-net hospitals should have equal access to the funding and resources that allows them to deliver the same standard of care as their counterparts.

KEYWORDS:

Cardiorespiratory morbidity; Mortality; Opioid overdose; Safety-net hospital

PMID:
30408618
DOI:
10.1016/j.jclinane.2018.10.036
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center