Drug Overdose ER-Inpatient Visits Definitions

This Web Query contains ER-Inpatient Visits data for Drug Overdoses generally, and Opioid subsets specifically.

The categories are not mutually exclusive and as follows:

A) DRUG OVERDOSES: ER visit or hospitalization involving any drug overdose (caused by acute poisoning only. Excludes alcohol). May include any over-the-counter, prescription, or illicit drug. Specifically:

• Any mention of ICD-10CM codes: T36-T50
  AND
  
• 6th character: 1-4, and a 7th character of A or missing
  OR
  
• 5th character: 1-4 where ICD-10CM is T36.9, T37.9, T39.9, T41.4, T42.7, T43.9, T45.9, T47.9, and T49.9, and a 7th character of A or missing.

B) ALL OPIOIDS SUBSET: ER visit or hospitalization involving any opioid overdose. Includes prescription opioid pain relievers (e.g., hydrocodone, oxycodone, and morphine), opioids used to treat addiction (e.g., methadone), as well as heroin, opium, and synthetic opioids (e.g., tramadol and fentanyl that may be prescription or illicitly-manufactured). Specifically:

• Any mention of ICD-10CM codes: T40.0X, T40.1X, T40.2X, T40.3X, T40.4X, T40.60, T40.69
  AND
  
• 6th character: 1-4, and a 7th character of A or missing.

C) HEROIN: ER visit or hospitalization involving a heroin overdose. Specifically:

• Any mention of ICD-10CM code: T40.1X
  AND
  
• 6th character: 1-4, and a 7th character of A or missing.

Note: ER visits and hospitalizations may represent multiple visits by the same individual. Also, figures are split roughly 61% ER, and 39% Hospital Discharge. Overall, ~1% were discharged dead (based on 2017-2019 data).

ICD10-CM Code Description

Poisoning by:

• T36-T50 (range includes all drugs)
• T40.0X (opium)
• T40.1X (heroin)
• T40.2X (other opioids)
• T40.3X (methadone)
• T40.4X (synthetic narcotics)
• T40.60 (unspecified narcotics)
• T40.69 (other narcotics)

Clinical Modifications for Intent/Initial Visit:

6th Character:

• 1 (accidental, unintentional)
• 2 (intentional self-harm)
• 3 (assault)
• 4 (undetermined intent)

7th Character:

• A (initial encounter) or missing

Age-Adjusted Rate

A weighted average of the age-specific rates, where the weights are the proportions of persons in the corresponding age groups of a standard population. The calculation of an Age-Adjusted Rate uses the year 2000 U.S. standard million. Benefit: Controls for differences in age structure so that observed differences in rates across areas such as counties are not due solely to differences in the proportion of people in different age groups in different areas. Rates are per 100,000 population.

ER-Inpatient Visits

The number of ER Visits and Hospital Discharges from non-Federal, acute-care, inpatient facilities. Only ER Visits and Hospital Discharges of Georgia residents who were seen in a Georgia facility are included.

Patients can be counted more than once if readmitted. Patients who were admitted through the ER but subsequently admitted as an inpatient are counted only once.

ER Visits and Hospital Discharges include patients discharged living or dead.

Since the number and rate reflect only ER Visits/Hospital Discharges, they do not include all existing cases (prevalence) or new cases (incidence) among residents of Georgia. ER-Inpatient Visits are reported by date of discharge, not admitting date.

ER-Inpatient Visit Rate

Formula = [Number of ER-Inpatient visits / Population] * 100,000.

Ethnicity

Hispanic or Latino includes persons of Mexican, Puerto Rican, Cuban, South or Central American, or other Spanish culture or origin, regardless of race. Non-Hispanic + Hispanic may not equal the total number of events due to persons of unknown ethnicity.

International Classification of Diseases, 10th Revision, (ICD-10)

An alphanumeric coding scheme that replaces ICD-9, and used for mortality data since 1999. ICD-10 codes were developed by the World Health Organization Collaborating Centres for Classification of Diseases.

Lifestages

An age year grouping methodology based upon predictable mortality. Georgia uses the following Lifestages: <1 Infancy, 1-4 Early Childhood, 5-12 Later Childhood, 13-19 Adolescence, 20-29 Early Adulthood, 30-44 Young Adulthood, 45-59 Middle Adulthood, 60-74 Late Adulthood, and 75+ Older Adulthood. The highest value for age is 120 years.

Non-Rural

Any county with 50,000 or more total population according to the United States decennial census of 2010 or any future such census (GA Code § 31-6-2 and 31-7-94.1).

Payor

Payor is the primary entity responsible for payment of services. Values for Payor include:

• Medicaid, based on Title XIX of the Social Security Act, is a Federal-State matching entitlement program that pays for medical assistance for certain vulnerable and needy individuals and families with low incomes and resources;
• PeachCare for Kids (Georgia's State Child Health Insurance Program (SCHIP)) is a program that provides comprehensive health care insurance for children through the age of 18 who do not qualify for Medicaid and live in households with incomes at or below the federal poverty level;
• Medicare is a health insurance program for people age 65 or older, some disabled people under age 65, and people of all ages with End-Stage Renal Disease (permanent kidney failure treated with dialysis or a transplant);
• Private Insurance includes Blue Cross / Blue Shield, HMO/Managed Care, Commercial Insurance, Other non-specified Managed Care, PPO (Preferred Provider Organization), POS (Point of Service Provider),State Health Benefit Plan (SHBP); and
• Self Pay includes patients with no proof of insurance, patients filing their own insurance claims, patients paying their own bills, Hill-Burton cases, charity cases, etc.; and
• Other (All other plans)
• Unknown Payor

Race

Per the Federal Office of Management and Budget, Directive 15 (1997),

• White is a person having origins in any of the original peoples of Europe, the Middle East or North Africa;
• Black or African-American is a person having origins in any of the black racial groups of Africa;
• Asian is a person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian subcontinent including for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand and Vietnam;
• American Indian/Alaska Native is a person having origins in any of the original peoples of North and South America (including Central America), and who maintains tribal affiliation or community attachment;
• Native Hawaiian or Other Pacific Islander is a person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands;
• Multiracial is a person declaring 2 or more of these races.

Rural

Any county having a population of less than 50,000 according to the United States decennial census of 2010 or any future such census (GA Code § 31-6-2 and 31-7-94.1).

Socioeconomic (SES) Vulnerability

Socioeconomic (SES) Vulnerability refers to the socioeconomic status domain/subset of the CDC’s Social Vulnerability Index (SVI) 2020. Socioeconomic vulnerability ranks census tracts within Georgia on 5 factors: below 150% poverty, unemployed, housing cost burden, no high school diploma, and no health insurance. Percentile ranking values range from 0 to 1, with higher values indicating greater vulnerability/lower socioeconomic status. Quintiles of the percentile rankings were used to create class breaks (Very Low, Low, Average, High and Very High SES Vulnerability). Keep in mind that “Very Low” SES Vulnerability equates to a High SES status. For more information see https://www.atsdr.cdc.gov/placeandhealth/svi/index.html. For data dictionary click here.

V1.8 (1/8/2024)