BACKGROUND: Opioids are generally an inappropriate acute pain management strategy in children, particularly because of the risk for diversion and subsequent misuse and abuse. OBJECTIVES: To examine associations between Medicaid plan type [coordinated care organization (CCO), managed care (MC), fee-for-service (FFS)] and whether a child received an opioid prescription. RESEARCH DESIGN: Secondary analysis of Oregon Medicaid data (January 1, 2016 to December 31, 2017). SUBJECTS: Medicaid-enrolled children ages 0-17 (N=200,169). MEASURES: There were 2 outcomes: whether a child received an opioid prescription from (a) any health provider or (b) from a visit to the dentist. Predictor variables included Medicaid plan type, age, sex, race, and ethnicity. RESULTS: About 6.7% of children received an opioid from any health provider and 1.2% received an opioid from a dentist visit. Children in a CCO were significantly more likely than children in a MC (P<0.01) or FFS (P=0.02) plan to receive an opioid from any health provider. Children in a CCO were also significantly more likely than children in MC or FFS to receive an opioid from a dentist visit (P<0.01). CONCLUSIONS: Pediatric opioid prescriptions vary by plan type. Future efforts should identify reasons why Medicaid-enrolled children in a CCO plan are more likely to be prescribed opioids.
BACKGROUND: Opioids are generally an inappropriate acute pain management strategy in children, particularly because of the risk for diversion and subsequent misuse and abuse. OBJECTIVES: To examine associations between Medicaid plan type [coordinated care organization (CCO), managed care (MC), fee-for-service (FFS)] and whether a child received an opioid prescription. RESEARCH DESIGN: Secondary analysis of Oregon Medicaid data (January 1, 2016 to December 31, 2017). SUBJECTS: Medicaid-enrolled children ages 0-17 (N=200,169). MEASURES: There were 2 outcomes: whether a child received an opioid prescription from (a) any health provider or (b) from a visit to the dentist. Predictor variables included Medicaid plan type, age, sex, race, and ethnicity. RESULTS: About 6.7% of children received an opioid from any health provider and 1.2% received an opioid from a dentist visit. Children in a CCO were significantly more likely than children in a MC (P<0.01) or FFS (P=0.02) plan to receive an opioid from any health provider. Children in a CCO were also significantly more likely than children in MC or FFS to receive an opioid from a dentist visit (P<0.01). CONCLUSIONS: Pediatric opioid prescriptions vary by plan type. Future efforts should identify reasons why Medicaid-enrolled children in a CCO plan are more likely to be prescribed opioids.
Authors: Kristel J M Janssen; A Rogier T Donders; Frank E Harrell; Yvonne Vergouwe; Qingxia Chen; Diederick E Grobbee; Karel G M Moons Journal: J Clin Epidemiol Date: 2010-03-24 Impact factor: 6.437
Authors: Joana Cunha-Cruz; Marilynn Rothen; Charles Spiekerman; Mark Drangsholt; Lyle McClellan; Greg J Huang Journal: Am J Public Health Date: 2014-02-13 Impact factor: 9.308