2016 to 2020 Saw Rise in Against-Medical-Advice Discharges for Opioid Admissions

WEDNESDAY, Jan. 3, 2024 (HealthDay News) -- Before-medically-advised (BMA) discharges increased to one in six patients from 2016 to 2020 for admissions with opioid use disorder (OUD) and an injection-related infection, according to a research letter published in the Dec. 4 issue of the Journal of the American Medical Association.

Ashish P. Thakrar, M.D., from the University of Pennsylvania Perelman School of Medicine in Philadelphia, and colleagues examined BMA discharge trends for opioid-related admissions (2016 to 2020). The analysis included admissions with OUD and an injection-related infection.

The researchers found that during the study period, the annual BMA discharge rate for admissions with OUD and an injection-related infection increased from 9.3 to 17.0 percent (annual growth rate, 1.8 percent). For comparison, for nonopioid mental health or substance use admissions, the BMA rate increased only marginally, from 3.1 to 3.5 percent (annual growth rate, 0.1 percent). The proportion of BMA discharges occurring before the third day did not significantly change for all opioid-related admissions (63.6 versus 62.1 percent; annual growth rate, −0.3 percent), but increased for admissions with OUD and an injection-related infection (42.6 versus 48.0 percent; annual growth rate, 1.1 percent).

"Among admissions with OUD and an injection-related infection, a higher proportion of BMA discharges occurred before the third day in 2020 versus 2016, suggesting that untreated withdrawal might contribute to increasing BMA discharges in this cohort," the authors write.

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