(391) Trends in Opioid Abuse Disorder Diagnoses, Hospitalizations, and Receipt of Guideline-Recommended Treatment After Hospitalization by Insurance Type, Sex, and Age (2021-2024)

Background: : Opioid misuse continues to be a public health crisis, but there is limited information on opioid use disorder (OUD) in privately insured populations. In spite of high costs related to OUD-related hospitalizations and the efficacy of medication assisted therapy, previous evidence has shown that many patients do not receive guideline recommended therapies to treat OUD.

Objective: : To evaluate 2021-2024 trends in OUD diagnoses rates, opioid-related hospitalizations, and receipt of recommended therapy.

Methods: : Retrospective analysis using Inovalon’s MORE2 database that includes nationally representative samples of commercially insured, Managed Medicaid (MM), and Medicare Advantage (MA) populations. Individuals were aged ≥18 with continuous enrollment during the measurement year. An OUD diagnosis was classified as 1 inpatient or 1 outpatient claim with an ICD-10-CM code for any OUD-related disorder (F11.XX). OUD-related hospitalizations were identified by an opioid ICD-10-CM code in any position on the inpatient claim. Buprenorphine, naltrexone, and methadone were considered recommended therapies (RT) based on US FDA guidelines. Descriptive statistics for diagnoses, hospitalizations, and receipt of RT within 30-days of hospital discharge were generated for 2021-2024 stratified by insurance type, sex, and age group.

Results: : The MM population had the highest OUD diagnoses rates (e.g. 2024, 3.1% vs 2.0% of MA and 0.6% of commercial). The proportion of OUD patients with an OUD-related hospitalization increased from 2021-2024 for commercial (14.0% to 16.1%) and MA (11.2% to 12.2%) but decreased for MM (17.0% to 15.9%). The percent of OUD patients receiving RT after hospitalization was highest in commercial patients (31.3% in 2024) and lower in MA patients (19.8% in 2024). A larger share of males had an OUD-related hospitalization compared to females (16.4% vs 14.6% 2024) and more males received RT (31.0% vs 28.5%). OUD-related hospitalizations were highest in those aged 18-34 (18.8%) and lowest in those aged ≥65 (12.0%). Conversely, 36.0% of OUD patients aged 18-34 received RT after hospitalization compared to just 11.8% of those over 65.

Conclusions: : Disparities in OUD diagnosis rates, hospitalizations, and receipt of recommended therapies were apparent by age, sex, and insurance type. Notably, fewer than one-fifth of MA and one-third of commercial OUD patients received RT within 30 days of opioid-related hospitalization. Treatment after hospitalization represents a critical opportunity window for interventions that can greatly reduce risk of overdose and death.

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