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- W2794996833 abstract "The opioid epidemic started in 1990s in the USA. Pennsylvania ranks 9th in the nation in the rate of long-acting pain reliever prescriptions. The objective of this dissertation is to (1) classify opioid-related hospitalizations and discharges of consequences of opioid use: HIV and Hepatitis C virus (HCV) among these classes. By HCV, HIV, and urbanicity, (2) we compared re-hospitalization rates, and (3) compared survival length.We used hospital discharges from the Pennsylvania Health Care Cost Containment Council and included primary and/or secondary discharge codes for opioid-related visits. Cancer-related visits, patients ages ≤8 years, and out-of-state residents were excluded. Latent class analysis (LCA) was performed using sociodemographics, substances, mental disorders, and pregnancy; logistic regression was used to compare HCV and HIV co-discharges among visits by latent class. We used semi-parametric mixed Poisson regression to compare re-hospitalization rates, and used accelerated failure time models to compare survival length, controlling for demographics, mental disorder, and other substance discharges. For these analyses, discharges after the first opioid-related hospitalization during 2000-2010 (opioid cohort) were used. LCA used 430,569 visits (202,126 individuals) with opioid-related codes during 2000-2014. Of the 5 latent classes (LCs), the LC Pregnant women, OUD had the highest percentage of HCV co-discharges: 5,273 visits (26.3%); Black, OUD, cocaine had the most visits with HIV: 6,490 (6.9%). Of 136,463 patients in the opioid cohort, there was a median of 4 visits per patient; those who died had a median survival of 92 weeks. Those with HCV had a 1.11 times higher re-hospitalization rate compared to non-HCV visits, and shorter survival lengths starting after age 30 years at index opioid visit. Those with HIV had a 1.38 times higher rate and 0.31 the length of survival.Although screening for HCV and HIV are not uniform for all opioid-related visits, it is important to specifically target pregnancy visits in high risk groups to be screened/treated for these diseases. This study has public health relevance, as higher re-hospitalization rates and shorter time to death in persons with the diseases indicates that increase in opioid-related hospitalizations, increases health issues due to HCV and HIV." @default.
- W2794996833 created "2018-04-06" @default.
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- W2794996833 date "2018-01-30" @default.
- W2794996833 modified "2023-09-24" @default.
- W2794996833 title "Classifications, re-visits, and mortality for opioid-related hospitalizations in Pennsylvania and their associations with HCV and HIV discharges" @default.
- W2794996833 hasPublicationYear "2018" @default.
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