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

By: Jeff Maser  Oct. 13, 2017

According to the CDC, more than half a million people have died between 2000 to 2015 & about 91 people die everyday from opioids. However, opioids do not always take their victims the first time around. Naturally, people who are readmitted to hospitals time and time again for opioid abuse are at higher risk for incurring an opioid related adverse event. By looking at readmittances for opioid poisoning nationally, we can begin to see the true prevalence of this widespread epidemic. To assess this statistic, Dexur analysts identified claims within the Medicare database to measure readmittance rates within a 30-60-90 day window.

The below chart shows the 30-60-90 day readmittance rates for the two ICD codes related to opioid poisoning. This chart shows patient readmittance rates of 27% and 29% within 30 days for the two forms of opioid poisoning. By measuring readmittances at 90 days, we see that the readmittance rates for both forms of opioid poisoning land at 42%.

The above data is from U.S. resident discharges between January and June 2015 and all raw data within this specific analysis is from CMS Medicare Inpatient claims data. The above statistics can be further supplemented by data from the HCUP 2014 database for the two aforementioned ICD codes (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 evidenced by the above table, each hospital stay with opioid poisoning costs about $10,000 per stay, with every extra day in the hospital costing the relevant hospital system about $2500/day. These costs are further compounded by more than 40% of these patients, who return to hospitals for treatment, according to the Dexur data. To improve care for patients with potential opioid addiction, treatment should be considered longitudinally so that both clinical and economic outcomes can be positively improved.