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Opioid Use Disorder Emergency Department Visits
The OUD-ED cohort is intended to characterize Opioid Use Disorder (OUD) burden through the lens of Emergency Department (ED) encounter data. The cohort represents ED visits with an indication of opioid use disorder, as determined by presence of an ICD code or chief complaint for opioid related overdose and/or other indications of opioid use disorder. This dashboard captures data at the visit level, so unique individuals may have more than one event captured in this dashboard. Accordingly, the number of OUD related ED visits per month is greater than the total number of individuals in the cohort.
Included in the dashboard are trend indicators which calculate 3-month, 6-month, and 1-year moving averages of OUD-ED encounter visits from January 1, 2015 to the present. Also, included are race, ethnicity, and age distributions of the OUD-ED cohort and county level breakdowns based on the current residence of the individual.
Cohort Definition
This cohort includes individuals from the Indiana Network for Patient Care (INPC) with an opioid use disorder related ED event between January 1, 2015 and the present (incremental refreshes will be done on a quarterly basis). Criteria for an OUD related ED event includes:
- An ED encounter with one or more of the following ICD codes included in principal diagnosis fields:
- 304.0 (Opioid type dependence) or
- 304.7 (Combination of opioid type drug with any other drug dependence) or
- 305.5 (Non-dependent opioid abuse) or
- 965.0 (Poisoning by opiates and related narcotics) or
- 970.1 (Poisoning by opiate antagonist) or
- E850.0 (Accidental poisoning by heroin) or
- E850.1 (Accidental poisoning by methadone) or
- E850.2 (Accidental poisoning by opiates and related narcotics) or
- E935.0 (Heroin causing adverse effects in therapeutic use) or
- E935.1 (Methadone causing adverse effects in therapeutic use) or
- E935.2 (Other opiates and related narcotics causing adverse effects in therapeutic use) or
- F11 (Opioid related disorders) or
- T40 (Poisoning by adverse effect of and under dosing of narcotics and psychodysleptics)
- Excluding codes related to cocaine, cannabis, LSD, and other psycodysleptics
OR
- An ED encounter with one or more of the following words in chief complaint field: heroin, opiate, opioid or narcan.
Data Source Descriptions
The cohort was derived from the Indiana Network for Patient Care (INPC). Please see a more detailed explanation of the INPC data source here.
*Please note that while this data source captures a large portion of Indiana residents, it is not representative of the entire State. Users should proceed cautiously when interpreting the data at the population level.
Notes on Methodology and Calculations
The comparisons of cohort distributions by race, age, and ethnicity utilize the demographic breakdown for the entire state of Indiana per data collected from the US Census Bureau, 2019 American Community Survey.
The county specific ED rates per 100,000 people were calculated using population data from the US Census Bureau, 2019 American Community Survey.
Geographic measurements were calculated using geocode data associated with the current home address of the individual and not the location of the event. Approximately 15% of individuals in the cohort have missing geographic variables and are not represented in the county specific measurements.
Neonatal Abstinence Syndrome (NAS)
The Neonatal Abstinence Syndrome (NAS) cohort is intended to characterize the burden of NAS and substance exposure for newborns. The cohort represents newborn infants who have been diagnosed as a substance-exposed newborn or a newborn with neonatal abstinence syndrome, as identified by presence of ICD code. For each individual within the cohort, the earliest known encounter with relevant ICD codes is considered the Index Encounter.
Included in the dashboard are trend indicators which calculate 3-month, 6-month, and 1-year moving averages of NAS Index encounters between January 1, 2015 and the present. Also, included are race and ethnicity distributions of the NAS cohort and county level breakdowns based on the current residence of the individual.
Cohort Definition
This cohort includes individuals from the Indiana Network for Patient Care (INPC ) who are aged 5 years or younger (at time of Index encounter) with the presence of at least one of the following ICD codes in their medical history between the time period of 1/1/2015 to present (incremental refreshes will be done on a quarterly basis):
- ICD code 779.5 (drug withdrawal syndrome in a newborn); or
- P96.1 (neonatal withdrawal symptoms from maternal use of drugs of addiction); or
- P04.14 (Newborn affected by maternal use of opiates (valid as of October 1, 2018); or
- P04.49 (Newborn affected by maternal use of other drugs of addiction).
Data Source Descriptions
The cohort was derived from the Indiana Network for Patient Care (INPC). Please see a more detailed explanation of the INPC data source here.
*Please note that while this data source captures a large portion of Indiana residents, it is not representative of the entire State. Users should proceed cautiously when interpreting the data at the population level.
Notes on Methodology and Calculations
The comparisons of cohort distributions by race and ethnicity utilize the demographic breakdown for the entire state of Indiana per data collected from the INPC which represents live births which took place over the time period of the cohort.
The denominator of live birth needed to calculate the NAS/substance exposed newborns per 1,000 live births measures were extracted from INPC over the same time period as the cohort definition. This controls for data capture limitations within the INPC and improves the interpretability of the raw counts. Live births were identified using a series of ICD codes as well as an age cutoff to ensure that only the newborn was counted, and not the mother.
Geographic measurements were calculated using geocode data associated with the current home address of the individual and not the location of the event. Approximately 15% of individuals in the cohort have missing geographic variables and are not represented in the county specific measurements.
Long-Term Opioid Therapy
The Long-Term Opioid Therapy (LTOT) cohort is intended to characterize individuals who have been prescribe LTOT. The primary purpose of this cohort is to create a more ready-made research registry for individuals who want to evaluate the health outcomes and healthcare utilization of individuals who have been prescribed LTOT.
Included in this dashboard are demographic indicators which describe the cohort as well a running count of health care encounters associated with this cohort.
Cohort Definition
This cohort includes individuals from the Indiana Network for Patient Care (INPC ) who have the following criteria in their medical history between the time of 1/1/2015 to present (incremental refreshes will be done on a quarterly basis):
- Individuals had at least one long-term episode defined as > 90 days with 120+ days supply of opioids or 10+ opioid prescriptions in a given year
OR
- Individuals had at least one record of ICD 10 code Z79.981 (Long term current use of opiate analgesic)
Data source descriptions
The cohort was derived from the Indiana Network for Patient Care (INPC). Please see a more detailed explanation of the INPC data source here.
*Please note that while this data source captures a large portion of Indiana residents, it is not representative of the entire State. Users should proceed cautiously when interpreting the data at the population level.
Notes on Methodology and Calculations
The comparisons of cohort distributions by race, age, and ethnicity utilize the demographic breakdown for the entire state of Indiana per data collected from the US Census Bureau, 2019 American Community Survey.
Geographic measurements were calculated using geocode data associated with the current home address of the individual and not the location of the event. Approximately 15% of individuals in the cohort have missing geographic variables and are not represented in the county specific measurements.
There are numerous ways to define LTOT with various medication dispensing and prescription data, and the definition chosen is not all encompassing.
The data for these dashboards and download files is derived from the INPC. While it is a comprehensive data set representing a large portion of the State, it does not cover all of Indiana. Accordingly, there may be discrepancies between State data and INPC-derived data. Additionally, the data sets may be subject issues related to data acquisition. For more detail on INPC, please visit: https://www.regenstrief.org/rds/data/#sources.