Hospitalizations for Pediatric Opioid Use Disorders: Exploring Racial Disparities among US Regions

Exposure to prescription opioids in the pediatric population is an important public health concern. Opioid hospitalizations among US children and adolescents have doubled in the last decade. There is an urgent need to better characterize the opioid epidemic in all pediatric populations across different racial groups and regions in the United States. However research on pediatric opioid use disorders (OUD) and health disparities has been sparse. This proposed study intends to fill this research gap through two specific aims: 1) to compare hospitalization patterns and outcomes among pediatric OUD nationally by race/ethnicity and US region and 2) to investigate how race and region are associated with variations in hospital care and subsequent clinical outcomes for pediatric patients with OUD and whether these two factors interact. We will pool three years of the most recent US Nationwide Inpatient Sample (NIS) a database maintained by the Agency for Healthcare Research and Quality as a part of the Healthcare Cost and Utilization Project. We are interested in determining whether racial disparities in hospital use and discharge outcomes exist among US regions for pediatric patients with OUD. Separate sets of regression models will be developed for each hospitalization outcome by examining univariate and multivariate associations with race and region. The proposed study will provide insight into the development of potential measures for comparison in future studies to assess underlying geographic disparities and racial differences simultaneously. Hospitalization is a key component of the continuum of care for children and adolescents with complex health problems including psychiatric and substance use disorders. Examining the effect of race and region in inpatient hospital care could inform policy and practice and lead to the development of specific and culturally congruent clinical and programmatic strategies. This proposal is unique in its use of the largest national dataset to study racial differences in the utilization of inpatient services for children and adolescents with OUD across the four US Census Bureau-defined regions. Findings will contribute to more informed policy and practice regarding this ongoing US public health crisis while addressing the unique health care needs of different racial groups across regions.