November 15, 2017

Cost of treating opioid overdose patients in ICU has risen by 58% over seven years, study finds

Daily Briefing

    The cost of treating opioid overdose patients in the ICU has increased 58% between 2009 and 2015, according to a study in the Annals of the American Thoracic Society, Casey Ross writes for STAT News.

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    Study details

    For the study, researchers at Beth Israel Deaconess Medical Center assessed about 23 million adult admissions to 162 academic hospitals in 44 states. According to the researchers, among the four million patients who required intensive care in the sample studied, 21,700 were admitted due to opioid overdoses.

    The researchers noted that the study assessed only academic hospitals, most of which are based in urban areas, meaning it may not reflect the extent of the opioid epidemic in rural areas or at community hospitals. Further, Jennifer Stevens—lead author of the study, associate medical director of the ICU at Beth Israel, and an associate professor at Harvard Medical School—said because the study relied on billing data, which does not always specify why a patient is admitted for care, the study could also underestimate the severity of the opioid overdose cases.

    Key findings

    The study found that the average cost of care for an opioid ICU admission increased by 58% from about $58,500 in 2009 to about $92,400 in 2015. According to the researchers, that growth rate far outpaced the average rate of medical inflation in the United States during the same seven-year timespan, which was about 19%.

    Further, the study found that opioid overdose patients are also dying more frequently, with annual deaths among such patients in ICUs almost doubling between 2009 and 2015. ICU deaths for opioid patients increased at a steady rate until 2012, the researcher said, when they started to spike.

    In addition, the researchers said many opioid overdose patients required longer periods of mechanical ventilation and sedation, and many are presenting with more severe symptoms of substance misuse, including kidney and liver failure.

    According to Ross, the study did not examine why overdose patients are arriving at the hospital in increasingly poor condition. However, the trend could reflect the more powerful level of opioids currently in circulation—such as fentanyl and carfentanil—as well as first responders' improved responses to opioid overdoses. In addition, as the scope of the opioid epidemic has grown, hospitals may be treating more patients with other health issues that make their overall condition more difficult to treat.

    Discussion

    Stevens said, "I was particularly struck that the mortality was increasing at such an alarming rate." She said it was "really, really concerning," adding, "U.S. critical care is awfully good and has a lot of resources, [but] we're still not able to save a lot of these lives."

    Stevens added that since the study "data g[o] through September of 2015, [she is] sure the story has continued in an even more complex way since then" (Ross, STAT News, 8/11).

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