Suboxone (Buprenorphine/Naloxone) is associated with Lower Hospital Readmission Rates for Narcotic Dependence Patients at Berkshire Medical Center based on Real World Evidence Study of Medicare Claims Data
In Suboxone, Narcotic Dependence
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By: Sara Riascos Mar. 31, 2022
Background:
Narcotic Dependence is frequently associated with hospital readmission. Readmission is a hospital quality measure that reflects dimensions of quality of inpatient care and also impacts overall programs by payors such as CMS’s Star Rating Program, HRRP and Value-Based Purchasing. Suboxone (Buprenorphine/Naloxone) is a combination of buprenorphine and naloxone, used to treat opioid addiction. Studies have shown that Suboxone (Buprenorphine /Naloxone) is effective in reducing opioid use short term relative to placebo.
Dexur’s analysis of Real-World Evidence based on Medicare Claims data showed that the use of Suboxone (Buprenorphine/Naloxone) within 7 days of hospitalization was associated with lower hospital readmission rates for Narcotic Dependence Patients at Berkshire Medical Center in Pittsfield, Massachusetts. Reduction in readmission rates helps hospitals improve their outcomes for various cost and quality programs. Dexur is an approved entity to perform Medicare claims data analysis, which it uses to perform quality outcomes analysis. Dexur has published several papers with Harvard Medical School on quality outcomes related topics. Dexur’s analysis of Drugs and their impact on quality outcomes, such as readmissions and mortality, are used by Hospitals, IDNs, and ACOs to implement best practices and manage Real World Evidence based risk factors.
Methods:
We conducted a retrospective study using Dexur’s analysis of Real-World Evidence from Medicare Claims data, for hospitalizations at Berkshire Medical Center between January 2017 to September 2019. Our methodology criteria was as follows:
- Inclusion Criteria: Selected Medical Hospitalizations with Primary Diagnosis with Narcotic Dependence related codes (Listed in table below)
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Stratified Selected population into cohorts
- Narcotic Dependence patients dispensed Suboxone (Buprenorphine/Naloxone) within 7 Days of Hospitalization using Part D drugs claims database
- Narcotic Dependence patients not dispensed with Suboxone (Buprenorphine/Naloxone) within 7 Days of Hospitalization
- 30 Day readmission rates were analyzed for both population cohorts
Results:
Overall, Suboxone (Buprenorphine/Naloxone) was associated with lower hospital readmission rates for all Primary ICD/DRG Diagnosis Codes examined at Berkshire Medical Center . For patients whose primary DRG Diagnosis was “Detoxification Services for Substance Abuse Treatment” (HZ2ZZZZ) and when Suboxone (Buprenorphine/Naloxone) was used within 7 days of hospitalization, the readmission rate was 35.29% compared to the cohort where Suboxone (Buprenorphine/Naloxone) was not used, whose readmission rate was 44.93%. The readmission odds ratio for these cohorts was 0.67. The use of Suboxone (Buprenorphine/Naloxone) was associated with a 33% lower readmission rate when used within 7 days of hospitalization. The full list of studied ICD/DRG codes, readmission rates, odds ratios, confidence intervals, and percentage reduction in readmission with Suboxone (Buprenorphine/Naloxone) at Berkshire Medical Center is shown below.
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| Primary ICD/DRG Diagnosis Code | Primary ICD/DRG Diagnosis Code Description | Total Hospitalizations without Suboxone (Buprenorphine/Naloxone) | Readmission Without Suboxone (Buprenorphine/Naloxone) | Readmission Rate without Suboxone (Buprenorphine/Naloxone) | Total Hospitalizations with Suboxone (Buprenorphine/Naloxone) | Readmission with Suboxone (Buprenorphine/Naloxone) | Readmission Rate with Suboxone (Buprenorphine/Naloxone) | Readmission Odds Ratio | Reduction in Readmission with Suboxone (Buprenorphine/Naloxone) (%) | Confidence Interval (-) | Confidence Intervals (+) |
|---|---|---|---|---|---|---|---|---|---|---|---|
| HZ2ZZZZ | Detoxification Services for Substance Abuse Treatment | 848 |  |
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Dexur also leveraged Medicare claims data to understand what percentage of patients hospitalized with Narcotic Dependence were not prescribed Suboxone (Buprenorphine/Naloxone) within 7 days of discharge.
| ICD/DRG CODE | Hospital | Hospitalizations with Narcotic Dependence | % of Hospitalizations without Suboxone |
|---|---|---|---|
| HZ2ZZZZ | Adcare Hospital Of Worcester | 7,644 | 99.56% |
| Berkshire Medical Center | 860 | 98.60% | |
| Turning Point Hospital | 4,453 | At Least 99.78% |
Hospitalizations with Narcotic Dependence = Above Listed ICD/DRG Codes
If figures are shared with “At Least” - this implies that the drug utilization within 7 days post hospitalization is less than 11
Conclusions:
According to analysis of Real-World Evidence of Medicare Claims data, for hospitalizations between January January 2017 to September 2019, the use of Suboxone (Buprenorphine/Naloxone) within 7 days of hospitalization can lead to substantial reductions in hospital readmission rates of Narcotic Dependence patients at Berkshire Medical Center . This analysis shows that a significant number of Patients are not dispensed Suboxone (Buprenorphine /Naloxone) after Narcotic Dependence hospitalizations at Berkshire Medical Center or major US Hospitals.
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