Oct 8, 2022 3 min read

Hospitalizations for opioid overdose in Pennsylvania decreased 27% over the past six years, from 2016 through 2021, according to a report released Thursday by the Pennsylvania Health Care Cost Containment Council.

In 2021, the statewide opioid overdose hospitalization rate was 22.9 per 100,000 residents, down from 31.6 per 100,000 residents in 2016.

The trend for Washington County followed a similar pattern as the statewide rate, the data shows, with 19.6 hospitalizations per 100,000 residents in 2021 compared to 33.9 hospitalizations per 100,000 residents in 2016.

However, Fayette County last year saw more hospitalizations for opioid overdoses than in 2016, with 35.2 hospitalizations per 100,000 in 2021 compared with 33.2 in 2016.

“The findings in this new report shed light on the status of Pennsylvania’s opioid epidemic over several years and emphasize the decrease in hospitalizations for opioid overdose since 2016,” Barry Buckingham, PHC4’s executive director, said in a news release. “While these results show decreases in the inpatient treatment of opioid overdoses in Pennsylvania, care provided in other settings such as emergency departments or by first responders may show different patterns.”

The council is an independent state agency charged with collecting, analyzing and reporting information that can be used to improve the quality and restrain the cost of health care in Pennsylvania.

The full report can be viewed at phc4.org.

The research differentiates between overdose hospitalizations for pain medication and heroin, while also highlighting trends across race/ethnicity and poverty level statewide.

Also, while the opioid overdose hospitalization numbers reflect overdoses that resulted in a hospital admission, they do not include all overdoses for Pennsylvania residents.

The research tracks the data but does not explore what’s driving the trends.

The report shows the largest decrease was between 2017 and 2018, when there was a 24% decrease in hospitalizations statewide from 3,500 to 2,667.

Since 2018, there has been minimal variation in the number of cases, but there was a small increase – about 7% – from 2019 to 2020 (from 2,468 to 2,633 annual hospitalizations), that coincided with the onset of the COVID-19 pandemic. In 2021, the number of hospitalizations fell to its lowest level since 2016 at 2,429.

According to the report, in 2021:

n Patients hospitalized for an opioid overdose spent a total of 11,750 days in the hospital.

n The average hospital stay was 4.8 days.

n Of the 2,429 hospitalizations for opioid overdose, 153 (6%) of the patients died in the hospital.

n And of that total number of patients, 54% had Medicaid as the anticipated primary payer, 26% had Medicare, 14% had commercial insurance, and 7% had another type or no insurance.

Of the statewide hospitalizations for opioid overdose last year, 427 (18%) were for fentanyl overdose and of the 153 overdose hospitalizations that ended in death, 52 (34%) were for fentanyl overdose.

Fentanyl is a synthetic opioid pain medication used for treating severe pain, but which is also manufactured illicitly and distributed through illegal drug markets. It is highly addictive and carries high risk for accidental death. Fentanyl is around 100 times more potent than morphine and 50 times more potent than heroin, according to the U.S. Drug Enforcement Administration.

In comparing hospitalizations for overdose of heroin versus pain medication, hospital stays for heroin overdose decreased 53% from 1,555 in 2016 to 724 in 2021, while stays for pain medication overdose showed less change, with only a 5% decrease from 1,787 in 2016 to 1,705 in 2021. About half (47%) of all opioid overdose hospitalizations in 2016 were for heroin overdose, while in 2021 that number decreased to about one-third (30%).

The findings showed hospitalization rates for opioid overdose decreased between 2016 and 2021 for white, non-Hispanic residents but increased over time for both Black, non-Hispanic residents and Hispanic residents.

Rates also increased over time for residents living in high poverty areas (poverty rate over 25%), while rates decreased for residents living in lower poverty areas.