Study: Fewer Than 1 in 5 Commercially Insured Patients Receive Post-Overdose Treatment

A study of national commercial insurance claims found that fewer than 1 in 5 patients obtained follow-up treatment after a non-fatal opioid overdose, and among those who had not received treatment for OUD prior to the overdose, patients who were of older age, female sex, black or Hispanic were less likely to receive follow-up care.

The study, led by Austin Kilaru, MD, from the Center for Emergency Care Policy and Research in the Perelman School of Medicine at the University of Pennsylvania, was published May 27 by JAMA Network Open.

Using an Optum administrative claims database, researchers on the project studied 6,451 deidentified adult patients discharged from the emergency department after treatment for an opioid overdose between Oct. 1, 2011, and Sept. 30, 2016. Follow-up treatment was defined as the presence of one pharmacy claim for medication for opioid use disorder or one medical claim for an outpatient or inpatient opioid treatment encounter. Of note: Methadone maintenance therapy, which was not covered by insurance for the population studied, was not included in the study.

Among the findings:

• 16.6% of patients obtained follow-up treatment within 90 days of their overdose
• Black patients were half as likely to obtain follow-up care vs. non-Hispanic white patients
• Women and Hispanic patients also were less likely to obtain follow-up
• Patients were 0.2% less likely to obtain follow-up with each additional year of age

In an interview with the Philadelphia Inquirer, Kilaru said the study was concentrated on patients with private insurance to see if it would level out disparities in access to care vs. Medicaid.

“We think of patients with Medicaid generally having worse access to care because of their insurance, especially around substance use treatment," Kilaru said. "There are more minorities in the Medicaid population, and we were wondering whether you could correct those disparities if you gave patients an even playing field with the kind of insurance they had. That wasn’t the case.”

Researchers were not able to pinpoint the cause of the racial disparities found in the study, Kilaru told the Inqurier.