Page 32 - Delaware Medical Journal - September/October 2018

Variation in Opiate Prescribing Practices Between an Urban and Suburban Hospital Staffed by the Same Emergency Medicine Providers
Morganne Phillips, MD; Brian Levine, MD; Mia Papas, Ph.D.; Christian Coletti, MD, MHCDS
Background: Availability of prescription opioids has increased nationally, but disproportionally in rural and suburban areas, with a concurrent higher rate of non-medical users and drug- related deaths in these areas. It is known from prior research that patients in rural areas are more likely to receive an opiate prescription at discharge than those in urban areas.
Objective: Determine the difference in the discharge opiate prescription rates between an urban and suburban hospital staffed by the same emergency medicine providers.
Methods: A descriptive study performed by retrospective review of opiate prescriptions written by the same medical providers in the emergency departments (EDs) of a smaller urban (55,000 visits) compared to a larger suburban (115,000 visits) hospital over one year.
Results: A two-proportion z-test was employed to examine differences between the proportion of opiate prescriptions between two hospital locations, an urban hospital and a suburban hospital. Data for both physicians and physician assistants’ prescriptions were combined into one category. Overall, more opiate prescriptions were written for patients at the suburban ED compared to the urban ED. At the urban ED, 16.5% of patients discharged from the urban ED received an opioid prescription, compared to 22.1% of those from the suburban ED (5.1%, 6.1%, <0.001).
Conclusions: Patients discharged from a large suburban ED are more likely to receive an opiate prescription than patients discharged from a smaller urban ED, despite receiving care from the same medical providers.
Keywords: opiate, prescription, urban, emergency medicine
Abstract