• Utsha G Khatri, Elizabeth A Samuels, Ruiying Xiong, MarshallBrandon D LBDLDepartment of Epidemiology, Brown University School of Public Health, Providence, RI, United States of America., Jeanmarie Perrone, and M Kit Delgado.
• National Clinician Scholars Program, Corporal Michael J. Crescenz Veterans Affairs Medical Center, University of Pennsylvania, Philadelphia, United States of America; Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, NY, New York, United States of America; Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, United States of America. Electronic address: Utsha.khatri@mountsinai.org.
• Am J Emerg Med. 2022 Jan 1; 51: 331-337.

Study ObjectiveEmergency departments (ED) are critical touchpoints for encounters among patients with opioid use disorder (OUD), but implementation of ED initiated treatment and harm reduction programs has lagged. We describe national patient, visit and hospital-level characteristics of ED OUD visits and characterize EDs with high rates of OUD visits in order to inform policies to optimize ED OUD care.MethodsWe conducted a descriptive, cross-sectional study with the 2017 Nationwide Emergency Department Sample (NEDS) from the Healthcare Cost and Utilization Project, using diagnostic and mechanism of injury codes from ICD-10 to identify OUD related visits. NEDS weights were applied to generate national estimates. We evaluated ED visit and clinical characteristics of all OUD encounters. We categorized hospitals into quartiles by rate of visits for OUD per 1000 ED visits and described the visit, clinical, and hospital characteristics across the four quartiles.ResultsIn 2017, the weighted national estimate for OUD visits was 1,507,550. Overdoses accounted for 295,954. (19.6%) of visits. OUD visit rates were over 8× times higher among EDs in the highest quartile of OUD visit rate (22.9 per 1000 total ED visits) compared with EDs in the lowest quartile of OUD visit rate (2.7 per 1000 ED visits). Over three fifths (64.2%) of all OUD visits nationwide were seen by the hospitals in the highest quartile of OUD visit rate. These hospitals were predominantly in metropolitan areas (86.2%), over half were teaching hospitals (51.7%), and less than a quarter (23.3%) were Level 1 or Level 2 trauma centers.ConclusionTargeting initial efforts of OUD care programs to high OUD visit rate EDs could improve care for a large portion of OUD patients utilizing emergency care.Copyright © 2021 Elsevier Inc. All rights reserved.

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