Patient Profiles and Settings of Care Following Opioid Use Disorder Related Hospitalizations in Medicare

Increasing opioid-related hospitalizations and emergency department visits among adults ≥65 years of age have been reported. Recent major federal efforts aim to improve the screening and management of opioid use disorder (OUD) in Medicare. The objective of this study is to understand the context of these hospitalizations with respect to the attributes of the patients, hospital admission, and the settings of care following opioid-related acute care use. We emphasize the skilled nursing facility (SNF) setting because it is a prominent care transition following hospitalization, and yet it is unclear if SNFs have the willingness, ability and/or capacity to manage OUD. The need for better integration of addiction treatment with both geriatric and post-acute medical care serves as the rationale of this study. To achieve the study goals, we will analyze administrative claims for 100% Medicare beneficiaries linked to nursing home assessments, and the Residential History File. The proposed research will provide data to promote awareness of OUD in SNFs, and among older adults, which can lead to improvements in clinical practice and policy to ensure appropriate monitoring and interventions are provided. Establishing and/or enhancing the capacity of SNFs to manage OUDs could improve resident quality of life and health outcomes while also contributing to national efforts to improve the management of OUD across different settings.