Skip to main content
Top
Published in: Oral and Maxillofacial Surgery 4/2022

20-01-2022 | Opioids | Original Article

Do rural oral and maxillofacial surgeons prescribe more postoperative opioids?

Authors: Jack A. Harris, Nisarg A. Patel, David A. Keith

Published in: Oral and Maxillofacial Surgery | Issue 4/2022

Login to get access

Abstract

Purpose

This study assesses rural–urban differences in opioid prescription practices among oral and maxillofacial surgeons (OMSs) who treated Medicare beneficiaries in 2017.

Methods

This cross-sectional study examines the 2017 Medicare Provider Utilization and Payment Dataset. The primary predictor variable was provider Rural–Urban Commuting Area code (rural versus urban). The primary outcome variable was mean opioid claims per Medicare beneficiary. Additional outcomes include total opioid claims volume, average Medicare beneficiaries and opioid cost per provider, mean days’ supply of opioids per opioid claim, and average percentage of Medicare Part D claims represented by opioid claims. Mann–Whitney U tests compared continuous variables. A least-squares regression identified correlates of opioid claims volume.

Results

Rural OMSs demonstrated a higher mean opioid claims per OMS and opioid cost per provider compared to urban surgeons. Urban OMSs prescribed a greater mean days’ supply of opioids per opioid claim. A larger percentage of Medicare Part D claims were represented by opioid claims for rural OMSs compared to urban OMSs. There were no differences in mean opioid claims per Medicare beneficiary. Male provider gender, female Medicare beneficiary gender, total number of beneficiaries, and a higher hierarchical condition category score were correlated with increased opioid claims per Medicare beneficiary for urban providers only.

Conclusion

Urban and rural OMSs prescribe a similar volume of opioids per Medicare beneficiary, with rural providers prescribing higher total volumes of opioids due to larger patient panels. This work indicates that rural and urban OMSs have similar opioid prescribing practices.
Literature
3.
go back to reference Substance Abuse and Mental Health Services Administration Center for Behavioral Health Statistics and Quality: Results from the 2017 National Survey on Drug Use and Health: Detailed Tables., 2018 Substance Abuse and Mental Health Services Administration Center for Behavioral Health Statistics and Quality: Results from the 2017 National Survey on Drug Use and Health: Detailed Tables., 2018
4.
5.
go back to reference Bicket MC, Long JJ, Pronovost PJ, Alexander GC, Wu CL (2017) Prescription opioid analgesics commonly unused after surgery: a systematic review. JAMA Surg 152:1066CrossRefPubMedPubMedCentral Bicket MC, Long JJ, Pronovost PJ, Alexander GC, Wu CL (2017) Prescription opioid analgesics commonly unused after surgery: a systematic review. JAMA Surg 152:1066CrossRefPubMedPubMedCentral
6.
go back to reference Baker JA, Avorn J, Levin R, Bateman BT (2016) Opioid prescribing after surgical extraction of teeth in Medicaid patients, 2000–2010. J Am Med Assoc 315(15):1653–1654CrossRef Baker JA, Avorn J, Levin R, Bateman BT (2016) Opioid prescribing after surgical extraction of teeth in Medicaid patients, 2000–2010. J Am Med Assoc 315(15):1653–1654CrossRef
9.
go back to reference Le Lait M-C, Martinez EM, Severtson SG, Lavery SA, Bucher-Bartelson B, Dart RC (2014) Assessment of prescription opioid intentional exposures across the rural-urban continuum in the United States using both population and drug availability rates. Pharmacoepidemiol Drug Saf 23:1334CrossRefPubMed Le Lait M-C, Martinez EM, Severtson SG, Lavery SA, Bucher-Bartelson B, Dart RC (2014) Assessment of prescription opioid intentional exposures across the rural-urban continuum in the United States using both population and drug availability rates. Pharmacoepidemiol Drug Saf 23:1334CrossRefPubMed
10.
go back to reference Lund BC, Ohl ME, Hadlandsmyth K, Mosher HJ (2019) Regional and rural–urban variation in opioid prescribing in the veterans health administration. Mil Med 184:894CrossRefPubMed Lund BC, Ohl ME, Hadlandsmyth K, Mosher HJ (2019) Regional and rural–urban variation in opioid prescribing in the veterans health administration. Mil Med 184:894CrossRefPubMed
11.
go back to reference Hudson TJ, Painter JT, Martin BC, Austen MA, Williams JS, Fortney JC, Sullivan MD, Edlund MJ (2017) Pharmacoepidemiologic analyses of opioid use among OEF/OIF/OND veterans. Pain 158:1039CrossRefPubMedPubMedCentral Hudson TJ, Painter JT, Martin BC, Austen MA, Williams JS, Fortney JC, Sullivan MD, Edlund MJ (2017) Pharmacoepidemiologic analyses of opioid use among OEF/OIF/OND veterans. Pain 158:1039CrossRefPubMedPubMedCentral
12.
go back to reference Prunuske JP, St Hill CA, Hager KD, Lemieux AM, Swanoski MT, Anderson GW, Lutfiyya MN (2014) Opioid prescribing patterns for non-malignant chronic pain for rural versus non-rural US adults: a population-based study using 2010 NAMCS data. BMC Health Serv Res 14:563CrossRefPubMedPubMedCentral Prunuske JP, St Hill CA, Hager KD, Lemieux AM, Swanoski MT, Anderson GW, Lutfiyya MN (2014) Opioid prescribing patterns for non-malignant chronic pain for rural versus non-rural US adults: a population-based study using 2010 NAMCS data. BMC Health Serv Res 14:563CrossRefPubMedPubMedCentral
13.
go back to reference Patel NA, Keith DA (2019) Five-year comparative analysis of medicare opioid prescription volume among oral and maxillofacial surgeons. J Oral Maxillofac Surg 77:2439CrossRefPubMed Patel NA, Keith DA (2019) Five-year comparative analysis of medicare opioid prescription volume among oral and maxillofacial surgeons. J Oral Maxillofac Surg 77:2439CrossRefPubMed
19.
go back to reference Monnat SM, Rigg KK (2018) The Opioid Crisis in Rural and Small Town America Monnat SM, Rigg KK (2018) The Opioid Crisis in Rural and Small Town America
20.
go back to reference American Association of Oral and Maxillofacial Surgeons (2020) Opioid Prescribing: Acute and Postoperative Pain Management American Association of Oral and Maxillofacial Surgeons (2020) Opioid Prescribing: Acute and Postoperative Pain Management
22.
go back to reference Harris JA, Patel NA, Ji YD (2020) Rural counties face inadequate access to oral and maxillofacial surgeons. J Oral Maxillofac Surg 78:1452CrossRefPubMed Harris JA, Patel NA, Ji YD (2020) Rural counties face inadequate access to oral and maxillofacial surgeons. J Oral Maxillofac Surg 78:1452CrossRefPubMed
23.
go back to reference Skinner E, Johnson T (2017) Oral health care in Rural America. NCSL Legisbrief 25:1PubMed Skinner E, Johnson T (2017) Oral health care in Rural America. NCSL Legisbrief 25:1PubMed
24.
go back to reference Burrows E, Suh R, Hamann D (2012) Health care workforce distribution and shortage issues in rural America. National Rural Health Association Policy Brief, pp 94105 Burrows E, Suh R, Hamann D (2012) Health care workforce distribution and shortage issues in rural America. National Rural Health Association Policy Brief, pp 94105
25.
go back to reference Chaudhary MA, Schoenfeld AJ, Harlow AF, Ranjit A, Scully R, Chowdhury R, Sharma M, Nitzschke S, Koehlmoos T, Haider AH (2017) Incidence and Predictors of Opioid Prescription at Discharge After Traumatic Injury. JAMA Surg 152:930CrossRefPubMedPubMedCentral Chaudhary MA, Schoenfeld AJ, Harlow AF, Ranjit A, Scully R, Chowdhury R, Sharma M, Nitzschke S, Koehlmoos T, Haider AH (2017) Incidence and Predictors of Opioid Prescription at Discharge After Traumatic Injury. JAMA Surg 152:930CrossRefPubMedPubMedCentral
26.
go back to reference Lancet Editorial Board (2021) A time of crisis for the opioid epidemic in the USA. Lancet 398:277CrossRef Lancet Editorial Board (2021) A time of crisis for the opioid epidemic in the USA. Lancet 398:277CrossRef
Metadata
Title
Do rural oral and maxillofacial surgeons prescribe more postoperative opioids?
Authors
Jack A. Harris
Nisarg A. Patel
David A. Keith
Publication date
20-01-2022
Publisher
Springer Berlin Heidelberg
Keywords
Opioids
Opioids
Published in
Oral and Maxillofacial Surgery / Issue 4/2022
Print ISSN: 1865-1550
Electronic ISSN: 1865-1569
DOI
https://doi.org/10.1007/s10006-021-01033-y

Other articles of this Issue 4/2022

Oral and Maxillofacial Surgery 4/2022 Go to the issue