121. Patient Perspectives On Adversity And Health

Abstract

prescription at discharge was the primary outcome of interest and was dichotomized based on receipt (i.e. yes or no) of an opioid. Covariates included: age, sex, race, insurer, surgical status, prescriber licensure, care unit from which patients were discharged, pain scores, and mental health diagnoses. Bivariate logistic regressions were calculated for all variables and the outcome of interest. Backward stepwise multivariate logistic regression was used to model the relationship between the variables of interest and the outcome of opioid prescription at time of discharge. Results: Overall, 31.5% of the sample was discharged with an opioid prescription. In bivariate analysis there were significant differences in the odds of receiving an opioid prescription by surgical status, age, race, payor status, pain score, and discharge unit. Multivariate analysis yielded similar findings. Controlling for other patient characteristics, surgery remained significantly associated with receiving an opioid prescription (OR: 4.00, p<0.001). Older age and higher pain scores before discharge also remained significant (OR: 1.12, p<0.001; OR: 1.14, p<0.001). Compared to patients with private insurance, those who self-pay or have Medicaid had lower odds of receiving an opioid upon discharge (OR: 0.63, p<0.001). Finally, being discharged from an ED was associated with lower odds of receiving an opioid prescription (OR: 0.09,p<0.001) while being discharged from a PACU/ICU or surgical floor was associated with higher odds (OR: 4.25,p<0.001; OR: 4.82,p<0.001). Conclusions: Our findings indicate that receiving an opioid prescription after an acute care stay of less than 48 hours is associated with a combination of factors including clinical conditions and sociodemographic data. Research demonstrates there is a large degree of variation in opioid prescribing patterns across the nation depending on a number of factors like provider, specialty, and patient population. This work contributes to the body of knowledge by characterizing opioid prescriptions at time of discharge from acute care in the adolescent population of a large pediatric health system.