The number of patients admitted with opioid use disorder and injection-related infections opting to be discharged against medical advice before completing treatment increased by 82% in 4 years, a recent Penn Medicine study found.
The study, published in JAMA, used data from the National Readmissions Database to compare rates of discharge in patients admitted for OUD to non-OUD admissions from 2016 to 2020. Researchers also evaluated changes in the discharge rates before the third admission day, when opioid withdrawal symptoms are most severe.
The study found the rate of discharge for OUD increased from 9.3% in 2016 to 17% in 2020, an 82% increase. Forty-eight percent of discharges occurred before the third day. In contrast, the discharge rate for non-opioid mental health or substance use admissions only increased from 3.1% to 3.5%.
"The rapid increase in early discharges is alarming; in 2016, less than one in ten patients admitted for OUD and injection-related infections left the hospital before their care team considered it safe. By 2020, one in six were leaving early," lead author Ashish Thakrar, MD, an assistant professor of medicine in the division of internal medicine at the University of Pennsylvania's Perelman School of Medicine, said in a Dec. 4 news release. "What's more, since the study period ended, the COVID-19 pandemic caused the opioid crisis to escalate, underscoring just how urgent it is to understand how we might be able to reverse this trend and get patients the treatment they need."