Skip to main content
SpringerLink
Log in

Does Opioid Use Disorder Matter for Health Care Utilization Among Lung Cancer Patients? Evidence from U.S. Hospitals During 2016–2020

  • Original Research Article
  • Published:
Clinical Drug Investigation Aims and scope Submit manuscript

Abstract

Background and Objective

The number of hospitalizations due to opioid use disorders in the USA increased steadily from 62,010 in 1998–2000 to 136,240 in 2015–2016; however, no health care utilization of lung cancer patients with opioid use disorder has been reported. The purpose of this paper is to investigate health care utilization due to opioid use disorder among lung cancer patients and to investigate additional charge status due to this disorder.

Methods

The National Inpatient Sample of the USA was used to identify lung cancer patients (n = 11,418, weighted n = 557,090) from 2016 to 2020. The characteristics of patient samples, temporal trend of opioid use disorder, and its association with health care utilization measured by hospital charges were thoroughly examined by the multivariate survey linear regression model.

Results

Among 557,090 lung cancer patients, 2.4% had opioid use disorder. The proportion of opioid use disorder among lung cancer patients during the study periods had continuously grown. Hospital charges also continued to increase during the study period and were higher among lung cancer patients with opioid use disorder. Survey linear results showed that opioid use disorder was associated with 12.6% higher hospital charges. Analysis of subgroups revealed that this trend was similar across p < the majority of social groups; however, it was significantly higher among Caucasian individuals (0.001) and self-pay groups (p = 0.035) than among others.

Conclusions

Research conducted has identified gaps in care in rural and suburban areas and a lack of equal care given to minority and low-income patients. These vulnerable groups access health care less often, are charged more for the care they receive, and often face multiple barriers to treatment. Unless these issues are addressed with a focus on socioeconomic factors, race, and region, the opioid epidemic will continue to negatively decimate these populations.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Siegel RL, Miller KD, Wagle NS, Jemal A. Cancer statistics, 2023. Ca Cancer J Clin. 2023;73(1):17–48.

    Article  PubMed  Google Scholar 

  2. Mercadante S, Vitrano V. Pain in patients with lung cancer: pathophysiology and treatment. Lung Cancer. 2010;68(1):10–5.

    Article  PubMed  Google Scholar 

  3. Tomaszewski KA, Püsküllüoğlu M, Biesiada K, Bochenek J, Nieckula J, Krzemieniecki K. Validation of the polish version of the eortc QLQ-C30 and the QLQ-OG25 for the assessment of health-related quality of life in patients with esophagi-gastric cancer. J Psychosoc Oncol. 2013;31(2):191–203.

    Article  PubMed  Google Scholar 

  4. Polanski J, Jankowska-Polanska B, Rosinczuk J, Chabowski M, Szymanska-Chabowska A. Quality of life of patients with lung cancer. OncoTargets Ther. 2016;9:1023–28.

  5. Schofield P, Ugalde A, Carey M, Mileshkin L, Duffy M, Ball D, et al. Lung cancer: challenges and solutions for supportive care intervention research. Palliat Support Care. 2008;6(3):281–7.

    Article  PubMed  Google Scholar 

  6. Potter J, Higginson IJ. Pain experienced by lung cancer patients: a review of prevalence, causes and pathophysiology. Lung Cancer. 2004;43(3):247–57.

    Article  PubMed  Google Scholar 

  7. Mystakidou K, Parpa E, Tsilika E, Pathiaki M, Galanos A, Vlahos L. Comparison of pain quality descriptors in cancer patients with nociceptive and neuropathic pain. In Vivo. 2007;21(1):93–7.

    PubMed  Google Scholar 

  8. WHO Guidelines for the Pharmacological and Radiotherapeutic Management of Cancer Pain in Adults and Adolescents. Geneva: World Health Organization; 2018.

  9. Schuckit MA. Treatment of opioid-use disorders. N Engl J Med. 2016;375(4):357–68.

    Article  PubMed  Google Scholar 

  10. Blanco C, Volkow ND. Management of opioid use disorder in the USA: present status and future directions. The Lancet. 2019;393(10182):1760–72.

    Article  Google Scholar 

  11. Sun EC, Darnall BD, Baker LC, Mackey S. Incidence of and risk factors for chronic opioid use among opioid-naive patients in the postoperative period. JAMA Intern Med. 2016;176(9):1286–93.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Barnett ML, Olenski AR, Jena AB. Opioid-prescribing patterns of emergency physicians and risk of long-term use. N Engl J Med. 2017;376(7):663–73.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Han B, Compton WM, Blanco C, Crane E, Lee J, Jones CM. Prescription opioid use, misuse, and use disorders in US adults: 2015 National Survey on Drug Use and Health. Ann Intern Med. 2017;167(5):293–301.

    Article  PubMed  Google Scholar 

  14. Jones CM. The paradox of decreasing nonmedical opioid analgesic use and increasing abuse or dependence—An assessment of demographic and substance use trends, United States, 2003–2014. Addict Behav. 2017;65:229–35.

    Article  PubMed  Google Scholar 

  15. Schiff DM, Work EC, Foley B, Applewhite R, Diop H, Goullaud L, et al. Perinatal opioid use disorder research, race, and racism: a scoping review. Pediatrics. 2022;149(3):e2021052368.

  16. Arthur J, Bruera E. Balancing opioid analgesia with the risk of nonmedical opioid use in patients with cancer. Nat Rev Clin Oncol. 2019;16(4):213–26.

    Article  PubMed  Google Scholar 

  17. Lipari RN, Hughes A. How people obtain the prescription pain relievers they misuse. In: The CBHSQ Report. Substance Abuse and Mental Health Services Administration (US), Rockville (MD); 2013.

  18. Florence C, Luo F, Xu L, Zhou C. The economic burden of prescription opioid overdose, abuse and dependence in the United States, 2013. Med Care. 2016;54(10):901.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Kirson NY, Scarpati LM, Enloe CJ, Dincer AP, Birnbaum HG, Mayne TJ. The economic burden of opioid abuse: updated findings. J Manag Care Spec Pharm. 2017;23(4):427–45.

    PubMed  Google Scholar 

  20. Starr TD, Rogak LJ, Passik SD. Substance abuse in cancer pain. Curr Pain Headache Rep. 2010;14:268–75.

    Article  PubMed  Google Scholar 

  21. Kwon JH, Tanco K, Park JC, Wong A, Seo L, Liu D, et al. Frequency, predictors, and medical record documentation of chemical coping among advanced cancer patients. Oncologist. 2015;20(6):692–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  22. Peterson C, Xu L, Mikosz CA, Florence C, Mack KA. US hospital discharges documenting patient opioid use disorder without opioid overdose or treatment services, 2011–2015. J Subst Abuse Treat. 2018;92:35–9.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Singh JA, Cleveland JD. National US time-trends in opioid use disorder hospitalizations and associated health care utilization and mortality. PLoS ONE. 2020;15(2): e0229174.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. Seth P, Scholl L, Rudd RA, Bacon S. Overdose deaths involving opioids, cocaine, and psychostimulants—United States, 2015–2016. Elsevier; 2018. p. 1556–68.

  25. Administration DE. National drug threat assessment. US Department of Justice; 2018.

  26. Kim SJ, Medina M, Chang J. Health care utilization of patients with opioid use disorder in US hospitals from 2016 to 2019: focusing on racial and regional variances. Clin Drug Investig. 2022;42(10):853–63.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Knox-Rice T, Xuan L, Wadsworth H, Halm EA, Rhodes RL. Examining the association between health care utilization and clinical characteristics among cancer patients in a safety net health system. J Palliat Med. 2019;22(1):80–3.

    Article  PubMed  Google Scholar 

  28. Ben J, Cormack D, Harris R, Paradies Y. Racism and health service utilisation: a systematic review and meta-analysis. PLoS ONE. 2017;12(12): e0189900.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Miron O, Barda N, Balicer R, Kor A, Lev-Ran S. Association of opioid use disorder with health care utilization and cost in a public health system. Addiction. 2022;117(11):2880–6.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Van Draanen J, Tsang C, Mitra S, Karamouzian M, Richardson L. Socioeconomic marginalization and opioid-related overdose: a systematic review. Drug Alcohol Depend. 2020;214: 108127.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Lee D-C, Liang H, Shi L. The convergence of racial and income disparities in health insurance coverage in the United States. Int J Equity Health. 2021;20(1):1–8.

    Article  Google Scholar 

  32. Qudah B, Maurer MA, Mott DA, Chui MA. Discordance in addressing opioid crisis in rural communities: patient and provider perspectives. Pharmacy. 2022;10(4):91.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Saloner B, McGinty EE, Beletsky L, Bluthenthal R, Beyrer C, Botticelli M, et al. A public health strategy for the opioid crisis. Public Health Rep. 2018;133(1_suppl):24S-34S.

    Article  PubMed  PubMed Central  Google Scholar 

  34. Williams AR, Nunes EV, Bisaga A, Pincus HA, Johnson KA, Campbell AN, et al. Developing an opioid use disorder treatment cascade: a review of quality measures. J Subst Abuse Treat. 2018;91:57–68.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Author notes

  1. Jeong-Hui Park, Sun Jung Kim have equal contribution.

Authors and Affiliations

  1. Department of Health Behavior, School of Public Health, Texas A&M University, College Station, TX, USA

    Jeong-Hui Park

  2. Department of Health Administration and Management, College of Medical Science, Soonchunhyang University, Asan, Republic of Korea

    Sun Jung Kim

  3. Center for Health care Management Science, Soonchunhyang University, Asan, Republic of Korea

    Sun Jung Kim

  4. Department of Software Convergence, Soonchunhyang University, Asan, Republic of Korea

    Sun Jung Kim

  5. Department of Pharmaceutical Sciences, Irma Lerma Rangel School of Pharmacy, Texas A&M University, 1114 TAMU, College Station, TX, U77843, USA

    Lily Grajeda, Alexiya Ramirez & Jongwha Chang

Authors
  1. Jeong-Hui Park
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Sun Jung Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Lily Grajeda
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Alexiya Ramirez
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Jongwha Chang
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jongwha Chang.

Ethics declarations

Funding

This paper was supported by Soonchunhyang University Research Fund, BK21 FOUR(Fostering Outstanding Universities for Research, No.:5199990914048, Korean Ministry of Education. The funding sources did not have interventions such as study design and data interpretation.

Conflicts of Interest/Competing Interests

The authors declare that they have no competing interests.

Informed Consent Statement

All participants realized enough for the study's purpose and signed written informed consent before participation.

Consent for Publication

Not applicable

Availability of Data and Material (data transparency)

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

Code Availability (software application or custom code)

Not applicable.

Authors' Contributions

JHP and JWC led the design and conception of the study, performed the data analysis, and wrote/reviewed the manuscript. SJK and LG contributed by writing the first draft of the manuscript. SJK and AR was reviewing and editing it. All authors read and approved the final manuscript.

Ethics Approval

The data we use are secondary data and all of the patient’s personal data are encrypted and unable to identify. This study was approved for waiver from the Institutional Review Board, Soonchunhyang University (202203-SB-027).

Supplementary Information

Below is the link to the electronic supplementary material.

Supplementary file1 (PDF 122 KB)

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Park, JH., Kim, S.J., Grajeda, L. et al. Does Opioid Use Disorder Matter for Health Care Utilization Among Lung Cancer Patients? Evidence from U.S. Hospitals During 2016–2020. Clin Drug Investig 43, 635–642 (2023). https://doi.org/10.1007/s40261-023-01297-0

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40261-023-01297-0

Search

Navigation