Ronan Matthew V, Herzig Shoshana J
Matthew V. Ronan (
Shoshana J. Herzig is a hospitalist in general internal medicine at the Beth Israel Deaconess Medical Center and an assistant professor of medicine at Harvard Medical School, both in Boston.
Health Aff (Millwood). 2016 May 1;35(5):832-7. doi: 10.1377/hlthaff.2015.1424.
Serious infection is a recognized complication of intravenous drug abuse and a major cause of morbidity and mortality among intravenous drug users. Trends in rates of serious infection and the associated costs related to opioid abuse/dependence have not been previously investigated in the context of the US opioid use epidemic. Our study, using a nationally representative sample of US inpatient hospitalizations, showed that hospitalizations related to opioid abuse/dependence both with and without associated serious infection significantly increased from 2002 to 2012, respectively, from 301,707 to 520,275 and from 3,421 to 6,535. Additionally, inpatient charges for both types of hospitalizations almost quadrupled over the same time period, reaching almost $15 billion for hospitalizations related to opioid abuse/dependence and more than $700 million for those related to associated infection in 2012. Medicaid was the most common primary payer for both types of hospitalizations. Our results characterize the financial burden on the health care system related to opioid abuse/dependence and one of the more serious downstream complications of this epidemic: serious infection. These findings have important implications for the hospitals and government agencies that disproportionately shoulder these costs and for clinicians, researchers, and policy makers interested in estimating the potential impact of targeted public health interventions on a national level.
严重感染是静脉注射吸毒公认的并发症，也是静脉注射吸毒者发病和死亡的主要原因。在美国阿片类药物使用流行的背景下，此前尚未对严重感染率的趋势以及与阿片类药物滥用/依赖相关的成本进行过调查。我们的研究使用了美国住院治疗的全国代表性样本，结果显示，与阿片类药物滥用/依赖相关的住院治疗，无论有无相关严重感染，在2002年至2012年间均显著增加，分别从301,707例增至520,275例，以及从3,421例增至6,535例。此外，这两种住院治疗类型的住院费用在同一时期几乎翻了两番，2012年与阿片类药物滥用/依赖相关的住院费用达到近150亿美元，与相关感染相关的住院费用超过7亿美元。医疗补助是这两种住院治疗类型最常见的主要支付方。我们的研究结果描述了与阿片类药物滥用/依赖相关的医疗保健系统的财务负担，以及这一流行更为严重的下游并发症之一：严重感染。这些发现对于承担这些成本比例过高的医院和政府机构，以及对于有兴趣在国家层面评估有针对性的公共卫生干预措施潜在影响的临床医生、研究人员和政策制定者具有重要意义。
