Rural residents admitted for opioid overdoses increasingly are hospitalized in urban hospitals


Clinical question: Is there an association between rurality and trends and characteristics of hospitalizations for opioid overdose?

Background: Hospitalization for an opioid overdose is an opportunity for intervention, and patients may have different discharge needs depending on their rurality. Differences in patient characteristics or overall trends in opioid overdose hospitalizations by rural status have not been described.

Study design: Time trend (2007-2014) and cross-sectional analysis (2012-2014).

Setting: Nationally representative sample of U.S. hospital discharges.

Dr. Joseph A Simonetti, a hospitalist at the University of Colorado at Denver, Aurora

Dr. Joseph A Simonetti

Synopsis: Using weighted data from the National Inpatient Sample and the American Community Survey, the authors found that 43,935 individuals were hospitalized for opioid overdose in the United States in 2007, increasing to 71,280 in 2014. A total of 99% of urban and 37% of rural residents were admitted to urban hospitals. Hospitalization rates for prescription opioid overdoses were higher among rural residents and increased among rural and urban residents until 2011 before declining among rural residents during 2012-2014. Hospitalization rates for prescription opioid overdoses increased among all groups before they declined among large urban population residents after 2011, declined among rural residents after 2012, and continued to rise among small urban residents. Hospitalization rates for heroin overdose increased across all years in all groups and were higher among urban as compared to rural residents.

Bottom line: Opioid overdose hospitalization is associated with patient rurality and a significant proportion of rural individuals are hospitalized for opioid overdose in urban facilities. These patients may have distinct discharge needs.

Citation: Mosher H et al. Trends in hospitalization for opioid overdose among rural compared to urban residents of the United States, 2007-2014. J Hosp Med. 2017. doi: 10.12788/jhm.2793.

Dr. Simonetti is a hospitalist at the University of Colorado School of Medicine.

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