From: State variation in opioid treatment policies and opioid-related hospital readmissions
Variable | 90-Day Readmission | |
---|---|---|
OR | 95% CI | |
Key Independent Variables | ||
 Naloxone standing orders | 1.14*** | 1.07–1.20 |
 Good Samaritan laws | 1.07 | 0.97–1.19 |
 Methadone coverage by Medicaid, by payer (reference: without methadone coverage)b | ||
  Medicaid | 1.23 | 0.97–1.56 |
  Medicare | 1.40** | 1.15–1.72 |
  Private insurance | 1.87*** | 1.44–2.41 |
  Uninsured | 1.57* | 1.06–2.33 |
  Other insurance/missing | 0.99 | 0.56–1.72 |
 MAT coverage generosity by Medicaid, by payer (reference: less generous coverage)c | ||
  Medicaid | 1.28** | 1.11–1.48 |
  Medicare | 0.80** | 0.70–0.91 |
  Private insurance | 0.74*** | 0.63–0.85 |
  Uninsured | 1.20 | 0.95–1.51 |
  Other insurance/missing | 1.14 | 0.86–1.50 |
Covariates | ||
Patient Sociodemographic Characteristics | ||
 Age | 0.99*** | 0.99–0.99 |
 Female | 0.86*** | 0.83–0.90 |
 Race/ethnicity (reference: White) | ||
  Black | 0.97 | 0.91–1.03 |
  Hispanic | 1.05 | 0.98–1.11 |
  Other | 0.97 | 0.89–1.05 |
  Missing | 0.78* | 0.63–0.97 |
 Median community-level income (reference: Quartile 4, highest) | ||
  Quartile 1 (lowest) | 0.87*** | 0.82–0.92 |
  Quartile 2 | 0.84*** | 0.79–0.89 |
  Quartile 3 | 0.87*** | 0.82–0.92 |
  Missing | 0.95 | 0.86–1.05 |
 Patient location: rural (reference: urban) | 0.84*** | 0.78–0.92 |
Patient Clinical Factors | ||
 Opioid-related diagnosis: principal (reference: secondary diagnosis only) | 1.88*** | 1.79–1.98 |
 Any opioid abuse or dependence | 0.83*** | 0.76–0.90 |
 Continuous opioid abuse or dependence | 1.16*** | 1.10–1.21 |
 Mental health co-occurring diagnosis | 1.09** | 1.03–1.15 |
 Alcohol abuse co-occurring diagnosis | 1.01 | 0.96–1.06 |
 Number of co-occurring physical conditionsd | 1.29** | 1.08–1.53 |
Initial Hospital Stay Characteristics | ||
 Hospital stay began in emergency department | 1.16*** | 1.11–1.22 |
 Length of index stay | 0.98*** | 0.98–0.99 |
 Receipt of rehabilitation during index stay | 1.96*** | 1.84–2.09 |
Hospital Characteristics | ||
 Percentage of annual opioid-related discharges in index year | 1.02*** | 1.02–1.03 |
 Alcohol/ SUD detoxification unit (reference: no unit) | ||
  Yes | 1.27*** | 1.20–1.34 |
  Not reported | 0.90 | 0.33–2.43 |
 Psychiatric acute care unit (reference: no unit) | ||
  Yes | 1.01 | 0.96–1.06 |
  Not reported | 1.23 | 0.45–3.33 |
State Factors | ||
 Medicaid coverage of all four ASAM recommended services | 0.74*** | 0.66–0.82 |
 Newly certified provider capacity for buprenorphine/naloxone per 100,000 state population during year of index stay | 1.00* | 1.00–1.00 |
 Number of opioid treatment programs per 100,000 state population during year of index stay | 0.35*** | 0.28–0.44 |
 SUD treatment capacity per 100,000 state population during year of index stay | 1.04*** | 1.03–1.04 |
 Opioid overdose death rate during year of index stay | 1.02* | 1.01–1.04 |