Prior studies have shown that hospital initiation of medication for opioid use disorder (MOUD) can improve OUD treatment retention post-discharge. This single-site retrospective cohort study of 470 patients with OUD sought to determine factors associated with hospital readmission. The study identified patients with OUD by ICD-9 or ICD-10 diagnostic codes, but additionally required that patients received at least 24 hours of opioid analgesics during the hospitalizations.
- Overall, the percentage of patients with OUD who were readmitted at 30 days (18%) and 90 days (32%) was similar to that of older patients with complex chronic illnesses.
- At the time of hospital admission, 23% of patients had existing prescriptions for buprenorphine and 27% were receiving methadone treatment.
- Patients with an existing prescription for buprenorphine were 53% less likely to be readmitted at 30 days (adjusted odds ratio [aOR], 0.47), and 43% less likely to be readmitted at 90 days (aOR, 0.57), compared with patients without an existing prescription for buprenorphine.
- Readmission risk at 30 and 90 days was not significantly increased for patients who were receiving methadone at the time of hospital admission, compared with patients not receiving methadone treatment.
- Patients with heroin use were 41% less likely to be readmitted at 90 days (aOR, 0.59), compared with those with non-medical use of prescription opioids.
- Buprenorphine initiated during the hospitalization did not change readmission risk, although this practice occurred rarely.
Comments: This study provides observational evidence that patients with OUD have high rates of readmission to the hospital. Being enrolled in buprenorphine treatment at the time of hospital admission appears to reduce patients’ with OUD overall risk of readmission at both 30 and 90 days, although overall hospital initiation of buprenorphine in the study was low.
Melissa Weimer, DO, MCR
Reference: Moreno JL, Wakeman SE, Duprey MS, et al. Predictors for 30-day and 90-day hospital readmission among patients with opioid use disorder. J Addict Med. 2019;13(4):306–313.