Trends of per-patient healthcare cost and resource utilization of opioid use disorder among privately insured individuals in the United States from 2005-2014

B. Jiang, Li Wang, D. Leslie
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Abstract

Background: Little are known about how per-patient healthcare cost and resource utilization of Opioid Use Disorder (OUD) have changed over time when governments continue to reduce availability and utilization barrier of OUD treatment. Objectives: Investigate trends of per-patient healthcare cost and utilization of outpatient, inpatient and emergency department services among privately insured individuals with OUD from 2005 to 2014. Methods: The MarketScan Commercial Claims and Encounters database was used to analyze healthcare cost and resource utilization of opioid used disorder from 2005 to 2014. A matched case-control design was employed to estimate the impact of OUD on healthcare cost and service utilization over this period. Main findings: Excess annual per-patient healthcare cost of OUD stayed relatively stable with an average of $14,586 between 2005 and 2014. However, excess outpatient cost increased while excess inpatient cost decreased over time. Among OUD patients, the increase of OUD related outpatient care utilization rate and average number of visits coincided with the decrease of inpatient and ED service utilization rates and average number of ED visits. Conclusions: Among OUD patients, the increasing per-patient utilization of OUD related outpatient care, together with the decline in per-patient utilization of more urgent care including inpatient and emergency department care might indicate increased awareness and diagnosis of OUD and a better control of the disease among existing patients with private insurance.
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2005-2014年美国私人保险个体阿片类药物使用障碍的人均医疗成本和资源利用趋势
背景:当政府继续降低阿片类药物使用障碍治疗的可获得性和利用障碍时,对阿片类药物使用障碍(OUD)的每位患者医疗保健成本和资源利用如何随时间变化知之甚少。目的:调查2005年至2014年私人保险OUD患者的人均医疗保健费用和门诊、住院和急诊服务的使用趋势。方法:采用MarketScan商业索赔和遭遇数据库,分析2005 - 2014年阿片类药物使用障碍的医疗成本和资源利用情况。采用匹配的病例对照设计来估计OUD在此期间对医疗保健成本和服务利用率的影响。主要发现:2005年至2014年间,OUD患者每年额外医疗保健费用相对稳定,平均为14,586美元。然而,随着时间的推移,超额门诊费用增加而超额住院费用减少。在OUD患者中,与OUD相关的门诊服务使用率和平均就诊次数的增加与住院和ED服务使用率和平均就诊次数的下降相一致。结论:在OUD患者中,与OUD相关门诊的人均使用率增加,而包括住院和急诊在内的急诊的人均使用率下降,可能表明现有私人保险患者对OUD的认识和诊断有所提高,对疾病的控制也有所改善。
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