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Residence in urban or rural counties in relation to opioid overdose mortality among Kentucky hospitalizations before and during the COVID-19 pandemic.
Blair, Lyndsey K; Howard, Jeffrey; Peiper, Nicholas C; Little, Bert B; Taylor, Kira C; Baumgartner, Richard; Creel, Liza; DuPre, Natalie C.
Afiliación
  • Blair LK; Department of Epidemiology and Population Health, University of Louisville School of Public Health and Information Sciences, United States; Lincoln Trail District Health Department, United States. Electronic address: lyndsey.blair@ltdhd.org.
  • Howard J; Department of Surgery, University of Louisville School of Medicine, United States; Louisville Metro Department for Public Health and Wellness, United States.
  • Peiper NC; Department of Epidemiology and Population Health, University of Louisville School of Public Health and Information Sciences, United States.
  • Little BB; Department of Health Management and System Sciences, University of Louisville School of Public Health and Information Sciences, United States.
  • Taylor KC; Department of Epidemiology and Population Health, University of Louisville School of Public Health and Information Sciences, United States.
  • Baumgartner R; Department of Epidemiology and Population Health, University of Louisville School of Public Health and Information Sciences, United States.
  • Creel L; Department of Health Management and System Sciences, University of Louisville School of Public Health and Information Sciences, United States; Commonwealth Institute of Kentucky, United States.
  • DuPre NC; Department of Epidemiology and Population Health, University of Louisville School of Public Health and Information Sciences, United States.
Int J Drug Policy ; 119: 104122, 2023 09.
Article en En | MEDLINE | ID: mdl-37473677
BACKGROUND: At the beginning of the opioid overdose epidemic, overdose mortality rates were higher in urban than in rural areas. We examined the association between residence in an urban or rural county and subsequent opioid overdose mortality in Kentucky, a state highly impacted by the opioid epidemic, and whether this was modified by the COVID-19 pandemic. METHODS: We captured hospitalizations in Kentucky from 2016 to 2020, involving an opioid using ICD-10-CM codes T40.0-T40.4 and T40.6. Patient's county was classified as urban or rural based on the NCHS Urban-Rural Classification Scheme. Multivariable logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) of opioid overdose mortality, adjusted for demographics, hospitalization severity, and zip code SES. We assessed effect modification by the COVID-19 pandemic. RESULTS: Overall, patients living in urban counties had 46% higher odds of opioid overdose death than patients residing in rural counties (adjusted OR=1.46; 95% CI=1.22, 1.74). Before the pandemic, patients in urban counties had 63% increased odds of opioid overdose death (adjusted OR=1.63; 95% CI=1.34, 1.97); however, during the COVID-19 pandemic, patients in urban and rural counties became more similar in regard to opioid overdose mortality (adjusted OR=0.72; 95% CI=0.45, 1.16; p-value for interaction =0.02). CONCLUSION: Before the pandemic, living in urban counties was associated with higher opioid overdose mortality among Kentucky hospitalizations; however, during the COVID-19 pandemic, opioid overdose mortality in rural areas increased, approaching rates in urban areas. COVID-19 posed social, economic, and healthcare challenges that may be contributing to worsening mortality trends affecting both urban and rural patients.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Sobredosis de Opiáceos / COVID-19 Límite: Humans País/Región como asunto: America do norte Idioma: En Revista: Int J Drug Policy Asunto de la revista: SAUDE PUBLICA / TRANSTORNOS RELACIONADOS COM SUBSTANCIAS Año: 2023 Tipo del documento: Article Pais de publicación: Países Bajos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Sobredosis de Opiáceos / COVID-19 Límite: Humans País/Región como asunto: America do norte Idioma: En Revista: Int J Drug Policy Asunto de la revista: SAUDE PUBLICA / TRANSTORNOS RELACIONADOS COM SUBSTANCIAS Año: 2023 Tipo del documento: Article Pais de publicación: Países Bajos