42% of Medicare Patients Hospitalized for Opioid Poisoning are Readmitted within 90 Days


America’s problem with the Opioid Crisis is well known & there is hardly a day that goes by without research & news on how this crisis can be combatted. According to the CDC, more than half a million people have died between 2000 to 2015 & about 91 people die everyday. We analyzed claims within the Medicare database to understand key opioid abuse hospitalizations & readmittance rates within a 30-60-90 day window.

The below chart for the two ICD codes related to opioid poisoning shows readmittance rates of about 27-29% within 30 days and 42% within 90 days.

The above data is from discharges between Jan to June 2015 from CMS Medicare Inpatient claims data. These statistics can be further augmented by data from from the HCUP 2014 database for the two ICD codes (which is shown in the below table).

ICD CodeICD Code DescriptionLength of StayAverage ChargesAverage Costs
All Payors
965Poisoning-Opium Nos4$37,235$9,588
965.09Poisoning-Opiates Nec3.9$35,898$9,046
Medicare Only
965Poisoning-Opium Nos4.3$39,175$9,855
965.09Poisoning-Opiates Nec4.2$37,350$9,375

As is evident from the above table, each stay costs about $10,000 per stay & every extra day in the hospital costs the system about $2500/day. These costs are further compounded by more than 40% of these patients returning to the hospitals for treatment. To improve care for patients with potential Opioid Addiction, treatment should be considered longitudinally across a longer time frame so that both clinical & economic outcomes are positively improved.

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