Health Disparities of Healthcare Utilization and Opioid Use Disorders Among Chronic Pain Patients: Examination of a Representative National Inpatient Sample of US Hospitals from 2016–2020

The study’s purpose is to examine temporal trends and associated healthcare utilization patterns related to opioid use disorders (OUDs) among individuals with chronic pain, while also exploring how patient characteristics such as race/ethnicity, age, household income, primary payer, residential status, and hospital attributes to healthcare charges and in-hospital length of stay attributed to OUDs within this demographic. The National Inpatient Sample (NIS) of the United States served as the dataset for this study, through which chronic pain patients (n = 39,070, weighted n = 195,350) were identified spanning the years 2016 to 2020. The study employed a multivariate survey linear regression model to comprehensively analyze the characteristics of patient samples, the temporal trend of OUDs, and their association with healthcare utilization, specifically measured by hospital charges. Patients with chronic pain aged over 40 years to under 70 years old indicated approximately 1.3 times increased likelihood of experiencing OUDs compared to those with chronic pain aged under 40 years old. Furthermore, among patients with chronic pain, White individuals exhibit a higher likelihood of having OUDs compared to other races/ethnicities such as Black, Hispanic, Asian or Pacific Islander, and Others. Residence in urban and Midwest regions demonstrated an elevated probability of OUDs when compared to their respective reference groups. However, chronic pain patients with OUDs within minority groups (e.g., Hispanic, Asian or Pacific Islander, and Others) displayed significantly elevated hospital charges and length of stays compared to their White counterparts (p < 0.001, respectively). We suggest a pressing need for policymakers to address racial and regional health disparities and advocate for cost and care parity for OUDs among chronic pain patients. Additionally, we suggest that further research is warranted to elucidate the underlying mechanisms driving opioid usage patterns and OUDs prevalence in chronic pain patients who live in the Midwest region, which may inform targeted interventions to mitigate the opioid crisis and improve public health outcomes in this area.