Burden of non-fatal opioid overdose hospitalizations on Medicaid

Background: The Medicaid population experienced an elevated risk of opioid overdose death. Higher risks of a health condition or worse health outcomes could mean high costs imposed on public sources of insurance. In this study, we compared the length of stay and total charge of hospitalized opioid overdose patients across insurance types to shed light on the financial burden of opioid epidemic across different types of payers. Method: Our sample includes all opioid overdose hospitalizations in the 2012-2013 South Carolina Patient Encounter database. Length of stay and total hospital charge are the two dependent variables. The key independent variable is the insurance status, categorized as: self-pay, commercial insurance, Medicare, Medicaid, and other payers (other government plan and charitable plans). Multilevel models were applied to account for the clustering effect of each hospital. The patients' age, gender, race/ethnicity, and Charlson Comorbidity Index were used as covariates. Results: A total of 1,262 hospitalizations were included. Medicaid patients stayed longer in hospital (beta = 1.815, 95% confidence interval = [0.406-3.224]) and had higher total charge (beta = $6,695.2, 95% CI = [215.1-13,175.3) compared with patients with commercial insurance. Conclusion: Medicaid patients' longer hospitalization and higher hospital charge suggest disparity at the hospital treatment stage.