PMU70 EVALUATING DIFFERENCES IN HEALTHCARE EXPENDITURES BETWEEN OPIOID USERS AND NON-USERS AMONG A NATIONALLY-REPRESENTATIVE SAMPLE OF OLDER UNITED STATES ADULTS WITH HYPERTENSION AND PAIN

To compare healthcare expenditures between older United States adults (≥50 years) with comorbid hypertension and pain who use opioid medications and those who do not. This study using 2017 Medical Expenditure Panel Survey (MEPS) data and employed a retrospective, cross-sectional database design. Individuals were eligible for study inclusion if they were alive for the calendar year, aged ≥50 years, had a diagnosis of hypertension, and reported having pain in the past four weeks. Hierarchical linear regression models were constructed to evaluate differences between opioid users and non-users for several categories of healthcare expenditures, including: inpatient; outpatient; office-based; emergency room; prescription medications; other; and total expenditures. Models adjusted for predisposing, enabling, need, personal health practices, and external environmental factors. An alpha level of 0.05 was set a priori. National estimates were obtained by adjusting for the complex MEPS design. This study involved 2,733 individuals (58.8% aged ≥65 years, 54.0% female, 78.4% white), of which 803 were opioid users. This provided a national estimate of 26,997,191 non-institutionalized older adults with comorbid hypertension and pain in the US in 2017, of which 7,930,252 (29.4%) were considered opioid users. After adjusting for predisposing, enabling, need, personal health practices, and external environmental factors, opioid users had 32% greater inpatient expenditures (β=0.274, p=0.0118), 50% greater outpatient expenditures (β=0.406, p<0.0001), 51% greater office-based expenditures (β=0.413, p<0.0001), 52% greater prescription medication expenditures (β=0.420, p<0.0001), 28% greater other healthcare expenditures (β=0.250, p=0.0068), and 79% greater total healthcare expenditures (β=0.583, p<0.0001), yet 8% lower emergency room expenditures (β=-0.084, p<0.0001) compared to non-users. Adjusted healthcare expenditures were greater among opioid users with hypertension and pain compared to non-users for all expenditure categories except emergency room expenditures, which were lower. Further research is necessary to investigate these expenditures in additional populations, in greater depth, and over longer time periods.