411 Emergency Department and Hospital Utilization After Emergency Department-Initiated Buprenorphine for Opioid Use Disorder

Document Type

Conference Proceeding

Publication Date

10-2-2023

Publication Title

Ann Emerg Med

Abstract

Objectives: The opioid crisis in the United States is a public health emergency. Emergency department (ED)-initiated buprenorphine with referral to ongoing care is an effective method to treat patients with opioid use disorder (OUD). While ED-initiated buprenorphine has been shown to be cost-effective, there is a paucity of data examining ED and hospital utilization after ED-initiated buprenorphine with referral to ongoing care. Our objective was to quantify ED and hospital utilization before and after ED-initiation of buprenorphine and referral to ongoing care. We hypothesized that patients would use the ED and be hospitalized at a lower rate after receiving ED- initiated buprenorphine and referral to ongoing care. Methods: We performed a retrospective chart review using health information exchange data of patients who were treated in our ED with buprenorphine beginning March 1, 2020 through December 31, 2021. Patients were included if there was documentation of referral to ongoing care after receiving ED-initiated buprenorphine. Patients were excluded if they received a home dose medication or were not referred to ongoing care. We quantified the number of ED visits and medical hospitalizations in the 1 year before and after the initial ED-initiated buprenorphine treatment visit. Analysis includes descriptive statistics and McNemar’s test to compare the proportion of patients pre or post ED-initiated buprenorphine that had ≥1 ED visit. Results: We identified 129 patients that were treated with ED-initiated buprenorphine and met the inclusion criteria. Total ED visits were reduced or zero in 76 (58.9%) of the patients after ED-initiated buprenorphine. Total hospitalizations were reduced or zero in 97 (75.2%) of the patients after ED-initiated buprenorphine. The odds ratio (OR) estimate of a patient having ≥1 ED visits following ED-initiated buprenorphine was lower (OR 0.57, 95% CI 0.26 – 1.16), though this did not meet statistical significance (p=0.096). Similarly, the odds of a patient having ≥1 admission was lower (OR 0.70, 95% CI 0.34 – 1.38) but did not meet statistical significance (p=0.262). Conclusions: In this retrospective chart review, the majority our patients visited the ED less and were admitted to hospital less after ED-initiated buprenorphine and referral to ongoing care. At this point in the data collection the study is underpowered to determine a significant difference. Further study is needed to quantify healthcare resource utilization after intervention with ED-initiated buprenorphine. No, authors do not have interests to disclose

PubMed ID

Not assigned

Volume

82

Issue

1097-6760, 0196-0644

First Page

S179

Last Page

S180

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