October 2022 Hospitalizations for Opioid Overdose, 2016 - 2021 PA Health Care Cost Containment Council \ This research brief looks at Pennsylvania residents, ages 15 and older, who were admitted to a Pennsylvania acute care hospital for an opioid overdose. Opioid overdoses of pain medication and heroin are displayed separately, but are also combined to show Heseflrflh totals. This analysis includes only overdoses that resulted in a hospital admission 4 (examples of cases not included: those treated with naloxone and/or treated in the Brlefs emergency department and not admitted to the hospital, or overdose deaths that occurred outside the hospital setting). Hospitalizations for Opioid Overdose Decreased 27% between 2016 and 2021 Hospitalizations for opioid overdose decreased 27% from a total of 3,342 in calendar year (CY) 2016 to 2,429 in CY 2021. Most of this decrease can be attributed to a decrease in hospitalizations for heroin overdose, which decreased 53% from 1,555 in 2016 to 724 in 2021. During the same time period, hospitalizations for pain medication overdose showed less change, with only a 5% decrease from 1,787 in 2016 to 1,705 in 2021. Number of Hospitalizations for Opioid Overdose 3,500 -- Opioid Type B Pain medication [ Heroin 3,342 2,667 2,633 2,468 2016 2017 2018 2019 2020 2021 Note: These numbers reflect overdoses that resulted in a hospital admission. They do not include all overdoses for Pennsylvania residents. Emergency department visits for opioid overdose are not included in these numbers. Hospitalizations for Opioid Overdose in 2021 Patients hospitalized for an opioid overdose spent a total of 11,750 days in the hospital. The average hospital stay was 4.8 days. @ 153 (6%) of the patients hospitalized for opioid overdose died in the hospital. @ Of the 2,429 hospitalizations for opioid overdose, 54% had Medicaid as the anticipated primary payer, 26% had Medicare, 14% had commercial insurance, and 7% had another type or no insurance. Note: Percentages do not add to 100% due to rounding. W Pennsylvania Health Care Cost Containment Council 1 Hospitalization Rates* for Opioid Overdose per 100,000 Residents in 2021 By Age: Age 15-24 8.8 Age 25-44 Age 45-64 Age 65-84 Opioid Type M Pain medication [] Heroin (Total opioid rate shown outside bars) Age 85 and older 7.3 73 By Sex: Female 16.4 Male By Race/Ethnicity: Black (non-Hispanic) Hispanic N o N White (non-Hispanic) wn wn = o N By Local Poverty Ratet Less than 10% Poverty 10.2 4 146 [y .'" R 10% to 25% Poverty N o )} Over 25% Poverty 18.7 57.3 The following categories of Pennsylvania residents had hospitalization rates significantly higher than the rest of the state: e Residents with Ages 25-44 years and 45-64 years e Male residents e Black (non-Hispanic) and Hispanic residents e Residents living in zip codes with poverty rates of 10% to 25%, and over 25% * Rates are calculated using PHC4 hospital discharge data and US Census Bureau 2020 population estimates. 1 Poverty rates are based on 2020 US Census Bureau estimates at the zip code level. Note: Hospitalization rates for pain medication and heroin overdose may not add to the total hospitalization rates for opioid overdose, due to rounding. Other race/ethnicity categories as well as unknown/missing values are not shown due to low volume. W Pennsylvania Health Care Cost Containment Council 2 Hospitalization Rates* for Opioid Overdose per 100,000 Residents, 2016 - 2021 By Race/Ethnicity: 50 Black 40 (non-Hispanic) 32.7 /\/_- 30 320 /\/y 20 |20.2 White (non-Hispanic) Rate per 100,000 Residents o 37.8 30.6 19.2 2016 2017 2018 2019 2020 By Local Poverty Ratet: 2021 Hospitalization rates for opioid overdose decreased for White (non- Hispanic) Pennsylvania residents from 2016 through 2021. However, rates increased for both Hispanic and Black (non-Hispanic) Pennsylvania residents during that same time. 70 Hospitalization rates were 60 consistently highest for @ Poverty Rate Over 25% 2L Pennsylvanians living in areas g 50 476 with poverty rates over 25%, and S 10 also increased from 2016 through & 344 2021. However, hospitalization = 30 /\m'erty Rate 10% to 25% rates for Pennsylvanians living in §- 20 251 o7 areas with lower poverty rates 5 14.6 decreased during that same time. 10 Poverty Rate Less than 10% 0 2016 2017 2018 2019 2020 2021 * Rates are calculated using PHC4 hospital discharge data and US Census Bureau 2020 population estimates. t Poverty rates are based on 2020 US Census Bureau estimates at the zip code level. New Data on Fentanyl Fentanyl is a synthetic opioid pain medication used for treating severe pain. However, it is also manufactured illicitly and distributed through illegal drug markets. Because of its high potency and illicit use, fentanyl has a high risk for misuse, abuse, dependence and overdose. Fentanyl-related overdoses became uniquely identifiable in CY 2021 hospital admission data. Of the 2,429 statewide hospitalizations for opioid overdose in 2021, 18% (427) were for fentanyl overdose. Furthermore, of the 153 overdose hospitalizations that ended in death, 34% (52) were for fentanyl overdose. W Pennsylvania Health Care Cost Containment Council Hospitalization Rates* for Opioid Overdose in 2021, by County Statewide Hospitalization Rate: 22.9 per 100,000 Residents Lawrence 239 Butler 9.4 Beaver 22.7 lorthampto, 18 4 NR . .3 6 ":' Dauphin /', 220 ontgome g Lancaster =t 15.2 - Chester hiladelnhi A, 111 PelawarefPniladelphia el Z NR: Not reported due to low volume. Allegheny 235 Westmoreland Washington 19.6 Somerset 17.7 Hospitalization Rate Per 100,000 Residents 7.7 18.8 29.9 40.9 52.0 * Rates are calculated using PHC4 hospital discharge data and US Census Bureau 2020 population estimates. Note that higher rates for some counties might reflect larger numbers of residents with certain at-risk characteristics (e.g., factors related to income, race/ethnicity, age and gender). County rates were not adjusted for those population differences so that important effects of these patient characteristics were not masked by such adjustment. About PHC4 Created by the PA General Assembly in 1986, the PA Health Care Cost Containment Council (PHC4) is an independent state agency charged with collecting, analyzing and reporting information that can be used to improve the quality and restrain the cost of health care in the state. Today, PHC4 is a recognized national leader in public health care reporting. PHC4 is governed by a board of directors representing business, labor, consumers, health care providers, insurers, health economists and state government. Barry D. Buckingham, Executive Director 225 Market Street, Suite 400, Harrisburg, PA 17101 717-232-6787 » www.phc4.org W Pennsylvania Health Care Cost Containment Council 4 A Opioid Overdose Hospitalization Rates* per 100,000 County Residents, 2016 - 2021 Calendar Year 2018 2019 Statewide 31.6 33.0 25.1 23.2 24.8 22.9 Adams 30.6 21.0 11.6 11.6 11.6 NR Allegheny 34.9 41.2 22.9 26.6 29.3 23.5 Armstrong 28.6 234 21.8 NR NR NR Beaver 40.7 31.6 27.5 18.1 21.9 22.7 Bedford NR NR NR NR NR NR Berks 25.7 31.4 22.7 24.7 20.0 35.4 Blair 31.1 37.1 14.7 24.6 24.8 24.8 Bradford 22.0 30.1 NR NR NR NR Bucks 34.1 38.2 32.0 26.4 23.7 20.5 Butler 11919 26.2 12.1 15.2 13.2 9.4 Cambria 51.3 51.8 21.7 18.2 32.2 34.0 Cameron NR NR NR NR NR NR Carbon 31.8 24.2 36.9 314 36.9 24.0 Centre 15.5 7.7 NR NR 8.5 7.7 Chester 24.6 249 19.3 16.1 13.2 11.1 Clarion NR NR NR NR NR NR Clearfield 17.6 20.6 17.7 20.7 19.4 14.9 Clinton NR NR NR NR 31.6 NR Columbia 37.2 44.6 NR 28.7 NR 19.8 Crawford 19.6 19.7 14.1 19.9 NR 14.3 Cumberland 23.8 135 17.2 20.0 14.6 8.9 Dauphin 314 30.3 23.1 20.3 19.3 22.0 Delaware 40.6 44.2 35.2 28.9 28.2 19.8 Elk NR NR NR NR NR NR Erie 35.6 37.3 22.3 20.7 14.4 20.2 Fayette 33.2 37.9 40.0 27.5 24.1 35.2 Forest NR NR NR NR NR NR Franklin 27.1 16.7 15.8 9.4 12.5 NR Fulton NR NR NR NR NR NR Greene NR NR NR NR NR NR Huntingdon NR NR NR NR NR NR Indiana 19.3 27.7 22.2 NR 19.6 19.6 Jefferson NR NR NR NR NR NR Juniata NR NR NR NR NR NR Lackawanna 42.1 27.4 21.2 14.3 21.3 28.7 NR: Not reported due to low volume. W Pennsylvania Health Care Cost Containment Council 5 Opioid Overdose Hospitalization Rates* per 100,000 County Residents, 2016 - 2021 (continued) Calendar Year 2018 2019 Lancaster 294 23.7 22.6 14.1 13.6 15.2 Lawrence 30.1 40.0 41.6 29.4 26.7 23.9 Lebanon 34.8 23.9 15.7 20.9 22.6 20.0 Lehigh 23.8 28.6 26.0 24.6 28.2 25.2 Luzerne 27.4 27.0 25.1 20.3 26.4 21.9 Lycoming 33.6 27.4 23.2 20.1 27.6 26.6 McKean NR NR NR NR NR NR Mercer 32.6 42.5 26.8 23.8 27.2 30.4 Mifflin NR NR NR NR NR NR Monroe 19.2 24.0 15.4 17.4 25.0 17.4 Montgomery 24.1 25.2 20.9 16.5 24.7 16.6 Montour NR NR NR NR NR NR Northampton 31.7 2919 22.3 24.2 20.6 18.3 Northumberland 36.2 20.8 28.8 224 30.3 15.8 Perry 37.0 29.0 31.6 NR NR NR Philadelphia 47.4 52.5 44.8 45.0 49.0 52.0 Pike NR NR NR NR NR NR Potter NR NR NR NR NR NR Schuylkill 25.0 27.6 22.7 24.5 16.1 18.6 Snyder NR NR NR NR NR NR Somerset 18.8 28.4 NR NR 17.7 17.7 Sullivan NR NR NR NR NR NR Susquehanna NR NR NR NR NR NR Tioga NR NR 29.4 NR NR NR Union NR NR NR NR NR NR Venango NR NR 34.7 NR NR NR Warren NR NR NR NR NR NR Washington 33.9 28.8 17.2 20.1 16.7 19.6 Wayne NR NR NR NR 27.0 24.8 Westmoreland 38.5 36.4 22.8 22,5 29.4 19.3 Wyoming NR NR NR NR NR NR York 28.7 39.8 30.0 24.2 235 16.5 NR: Not reported due to low volume. * The 2020 US Census Bureau population estimates are the latest available at the time of publication, therefore the 2021 rates are calculated using 2021 PHC4 hospital discharge data and 2020 US Census Bureau population estimates. Earlier years use both the hospital discharge data and population estimates from the corresponding year. W Pennsylvania Health Care Cost Containment Council 6