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2016 年至 2018 年美国阿片类药物相关住院治疗的模式和负担。

Pattern and burden of opioid-related hospitalizations in the USA from 2016 to 2018.

机构信息

Department of Hospital Medicine UPMC East, Pittsburgh, PA, USA.

Department of Hospital Medicine, Asante Rogue Regional Medical Center, Medford, OR, USA.

出版信息

Br J Clin Pharmacol. 2021 Nov;87(11):4366-4374. doi: 10.1111/bcp.14857. Epub 2021 May 4.

Abstract

AIMS

The current opioid crisis in the USA is a formidable challenge for the healthcare system, and the general population. Our objective is to characterize the burden of opioid-related disorders in an inpatient setting in the USA for the years 2016, 2017 and 2018 using the National Inpatient Sample (NIS).

METHODS

A cross-sectional analysis of the NIS was performed to identify and analyse hospitalizations with an opioid-related diagnosis in 2016, 2017 and 2018. Descriptive statistics and regression models were utilized to define the demographics of the population of interest and measure the outcomes.

RESULTS

We identified 962 900 discharges with opioid-related diagnosis in 2016, 982 710 in 2017 and 942 110 in 2018. The majority were age <60 years, were found in residents of low-income zip codes and covered by Medicaid. The adjusted mean total hospitalization cost trended up from $12 828 (95% confidence interval [CI] 12 547-13 108) in 2016, to $13164.9 (95% CI 12 872.47-13 457.34) in 2017 and then to $13 626.65 (95% CI 13 325.95-13 927.34) in 2018. The adjusted mortality was highest in 2016; 2.26% (95% CI 2.16-2.35) and it trended down to 1.97% (95% CI 1.88-2.05) in 2017, and to 1.89% (95% CI 1.81-1.98) in 2018.

CONCLUSIONS

Opioid-related disorders cause a significant number of hospitalizations in the USA. A large proportion of these patients are age <60 years, have lower household income, and are covered by Medicaid. Programmes directed towards this specific group can help reduce the overall burden of hospitalizations.

摘要

目的

目前美国的阿片类药物危机是医疗保健系统和普通民众面临的一个巨大挑战。我们的目标是使用国家住院患者样本(NIS),描述 2016 年、2017 年和 2018 年美国住院患者中与阿片类药物相关的疾病负担。

方法

对 NIS 进行横断面分析,以确定并分析 2016 年、2017 年和 2018 年与阿片类药物相关的诊断住院患者。利用描述性统计和回归模型来确定相关人群的人口统计学特征,并衡量结果。

结果

我们确定了 2016 年有 962900 例与阿片类药物相关的诊断出院,2017 年有 982710 例,2018 年有 942110 例。大多数患者年龄<60 岁,居住在低收入邮政编码地区,由医疗补助计划覆盖。调整后的平均总住院费用从 2016 年的 12828 美元(95%置信区间[CI]为 12547-13108)呈上升趋势,到 2017 年的 13164.9 美元(95%CI 为 12872.47-13457.34),然后到 2018 年的 13626.65 美元(95%CI 为 13325.95-13927.34)。调整后的死亡率在 2016 年最高,为 2.26%(95%CI 为 2.16-2.35),随后在 2017 年下降至 1.97%(95%CI 为 1.88-2.05),在 2018 年下降至 1.89%(95%CI 为 1.81-1.98)。

结论

与阿片类药物相关的疾病在美国导致大量住院患者。这些患者中有很大一部分年龄<60 岁,家庭收入较低,由医疗补助计划覆盖。针对这一特定群体的项目可以帮助减轻住院治疗的总体负担。

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