New Washington Health Alliance report finds that where people live influences their likelihood of getting opioid prescriptions and other treatments and procedures
As many as one in six women age 45–64 in some communities were prescribed opioids in a one-year period
SEATTLE, August 11, 2016 – On average, more than one in 12 commercially and Medicaid insured adults in Washington received at least one prescription for an opioid in a one-year period covered by a report issued today by the Washington Health Alliance (Alliance). The report, Different Regions, Different Care: A Report on Procedure Rate Variation in Washington State, found that variation among different parts of the state is pronounced, with prescription rates varying by as much as threefold or more, depending on the age and gender of the patient.
“With this analysis, the Alliance offers a unique perspective on opioid use in our state,” said Nancy A. Giunto, executive director of the Alliance. “We believe that this information will help inform the ongoing conversation about opioid prescribing in Washington. More importantly, we hope that the data will lead to further action to address this tragic problem.”
“Opioid addiction is taking a terrible toll on communities, people and families across our state,” said Gov. Jay Inslee. “While the state has been a leader in tackling this epidemic, 600 people still die every year in Washington state from opioid overdoses. The Washington Health Alliance’s report highlights the need for us to do even more to reach out to and educate doctors and to provide treatment services to patients in pain or who may be addicted to painkillers. My administration will use this data to inform action steps that I intend to announce soon to make improvements to reduce opioid use in our state.”
While opioid use is a problem across the state, the Alliance’s report reveals that prescribing patterns can vary widely, depending on where someone lives. Among the key findings:
- Approximately one in six women ages 45 to 64 in Arlington, Enumclaw and Olympia were prescribed opioids in the year the report covers.
- Some cities, such as Bellevue, have opioid prescription rates consistently below the state average for all age groups and both genders, while others, like Kennewick, are consistently above the state average.
- In the highest prescribing regions, approximately one in ten girls and one in thirteen boys aged 12–19 years received at least one prescription for an opioid in the reporting period, rates that suggest that prescriptions go far beyond the palliative care for a major, severe illness.
- Girls ages 12 to 19 in Port Angeles are supplied opioids for an average of 45 days, compared to an average of a week for their peers in Enumclaw.
Especially eye-opening are prescription rates for young children. For example, in the region with the highest rate, four percent of boys ages two to six received at least one opioid prescription during the year, almost six times the rate as boys in the region with the lowest rate. At the highest rate, one in 25 young boys received a prescription for these powerful painkillers during the year.
Opioid prescribing is just one of 22 treatments and procedures covered in the Alliance’s report. In practical terms for patients, the findings show that you may be more likely to have a specific medical test or procedure depending on where you live. Additional examples in the report include:
- One-year old girls in Spokane are 120 percent more likely to have eardrum procedures.
- Young women in Everett are more than two and a half times more likely to have bariatric surgery.
- Middle aged men in Yakima are 70 percent more likely to have spine fusion surgery; their counterparts in Seattle are 50 percent less
The Alliance issued another report on variation in health care this week. The report, Less Harm, Less Waste: Choosing Wisely in Washington State, offers county-by-county results for 10 different Choosing Wisely® recommendations. The report was released in conjunction with the Washington State Choosing Wisely Task Force, a group of more than 20 medical leaders from the largest health care organizations in the state. The Task Force is co-sponsored by the Alliance, the Washington State Medical Association (WSMA) and the Washington State Hospital Association (WSHA). The Alliance has partnered with Qualis Health to supplement the available data with Medicare results for three measures in the report.
Choosing Wisely® is an initiative of the American Board of Internal Medicine (ABIM) Foundation. The goal of Choosing Wisely is to help providers and patients have conversations about the necessity of tests and procedures and support efforts to help patients make smart and effective care choices. The report was made possible thanks to support from the ABIM Foundation and the Robert Wood Johnson Foundation.
Among the report’s key findings:
- Variation between counties remains high.
- 26 percent of Washington patients with upper respiratory infections were prescribed potentially unnecessary antibiotics.
- Fewer women are receiving Pap tests too frequently compared to 2011-2012 results.
- There is an increase in people receiving imaging scans for low-back pain compared to 2011-2012 results.
- Washington’s children are receiving fewer CTs for appendicitis compared to 2011-2012 results.
- 42 percent of Washington women with simple adnexal cysts had a potentially unnecessary follow-up imaging test.
While neither report can answer why such variation is common across our state, they do highlight the importance of patients—and their caregivers—being engaged in their treatment. Patients should understand all of their options and work with their provider and health care team to make the decision that is best for them. Each treatment option carries its own benefits and risks, many of them significant. Since they are the one who will bear them, patients need to take an active role to ensure that they make the decision that is best for them.
Both reports are available at www.wahealthalliance.org/alliance-reports-websites/alliance-reports/.
John Gallagher, Director of Communication and Development
Washington Health Alliance
Edit: This release was edited to correct the population covered in the Different Regions, Different Care report. The report shows results for commercially insured and Medicaid insured.