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阿片类镇痛药处方使用率对创伤康复成本的影响:来自可赔偿的骨科道路创伤患者的证据。

The impact of opioid analgesic prescription uptake on the costs of recovery from injury: Evidence from compensable orthopaedic road trauma patients.

机构信息

School of Economics, Yonsei University. Postal address: 50 Yonsei-ro, Seodaemun-gu, Seoul 03722, South Korea.

The Cube Group, Postal address: 7/136 Exhibition Street, Melbourne, VIC, 3000, Australia.

出版信息

Accid Anal Prev. 2018 Aug;117:32-39. doi: 10.1016/j.aap.2018.03.032. Epub 2018 Apr 6.

Abstract

Long-term opioid prescribing after compensable orthopaedic injury may contribute to the 'long right tail' in the cost of recovery. The aim of this study was to estimate the effect of prescription opioid uptake on injury compensation cost, using orthopaedic road traffic injury claims data from Victoria, Australia. We used a maximum likelihood estimation that accounts for potential endogeneity associated with opioid uptake, utilizing information on the doctor's differential propensity to prescribe opioids when treating other compensable injury patients. Our results suggest that opioid recipients incurred significantly greater hospital costs, income compensation payments, and medical and paramedical expenses. Overall, income compensation was the primary driver of the claim cost difference between opioid recipients and non-recipients. The findings imply that there is scope to impose restrictions on long-term opioid usage, and to encourage the use of alternative pain relief medicines.

摘要

长期开具阿片类药物处方可能导致赔偿性骨科损伤恢复成本的“长尾”。本研究旨在利用澳大利亚维多利亚州骨科道路交通伤害索赔数据,估计阿片类药物使用对伤害赔偿成本的影响。我们使用最大似然估计来解释阿片类药物使用的潜在内生性,利用医生在治疗其他可赔偿损伤患者时开具阿片类药物的差异倾向信息。我们的结果表明,阿片类药物使用者的住院费用、收入补偿支付以及医疗和辅助医疗费用显著增加。总体而言,收入补偿是阿片类药物使用者和非使用者之间索赔成本差异的主要驱动因素。研究结果表明,限制长期使用阿片类药物并鼓励使用替代止痛药具有一定的可行性。

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