In a technical test-posting last week, I reworked the dataset used by Medicare to show where prescriptions of opioids to Part-D Medicare patients were written in Kentucky in 2013 by five-digit Zip Code. I reworked the data to add the average number of opioid prescriptions written by an opioid prescriber in that zip code. This supplements Medicare’s own calculation of the percent of all prescriptions that are for opioids in a given area. Both these indices provide insight into the intensity of opioid prescribing in a given area. In today’s posting, I add a map of the same data broken down by Kentucky county. Not surprisingly, significant geographic variation exists in both maps that is compatible both with public perception of places where prescription drug abuse is prevalent, and locations where individual prescriber outliers practice. This particular dataset is based on the principal business address of the prescriber, but I have shown that prescribing of opioids to Medicare patients correlates strongly with prescribing to all patients, and that not unexpectedly, the location of the prescriber predicts were the patients live. Descriptions of the underlying data and caveats for its use are discussed in earlier articles.
Mapping by county:
Below is a map of opioid prescribing to Medicare patients by county. The maps are fully interactive. The viewer can use the legend to switch from one measured index to another, or to zoom in on various areas. Clicking on a shaded area displays the underlying data for that county.
View a larger version of CMS Opioids KY Counties 2013 created with eSpatial mapping software.
Continue reading “Mapping Part-D Medicare Opioid Prescriptions in Kentucky By County and Zip Code”
Both “hot- and cold-spots” of opioid prescription are easily found. The business address and volume of opioid prescriptions written by Medicare prescribers correlates very well with the volume of opioids consumed by non-Medicare patients and predicts where where they live. The Medicare Part-D Prescription Drug Database can be a useful instrument for medical professional, public health, and law enforcement organizations in dealing with America’s exploding prescription drug and opioid drug epidemic.
In its efforts to make our healthcare system more transparent, affordable, and accountable, the Cabinet for Medicare and Medicaid Services (CMS) has just released an on-line website tool map Medicare Opioids that allows anyone to create maps showing the distribution of prescribing for opioids at the state, county or 5-digit ZIP Code level. The underlying data comes from the same initial release of 2013 Part-D Medicare prescription data and is therefore geographically organized by the business address of each individual prescriber but is limited to the subset of patients covered by Part-D Medicare.
However, data accompanying the mapping application includes information not available in the earlier release including the number of prescribers in a given geographic area, and the percentage of all prescriptions written that were for opioids. (Who else could do this!) With this additional information, the number of opioid prescriptions per-prescriber within a given geographic region can be calculated. A few minutes of browsing easily demonstrates major geographic variation and “hot-spots” of both high- and low opioid prescribing at the five-digit ZIP Code level. Continue reading “Medicare Releases On-Line Application To Map Opioid Prescriptions.”
This appears to be the case in Ohio.
Cities and towns in Ohio in which medical professionals write opioid prescriptions to Medicare beneficiaries at the very highest rate per inhabitant are co-located in counties with the highest per-capita consumption of prescription opioids overall and those with problems of prescription drug abuse in general. In Ohio these areas are in southern Ohio and the I-77 corridor in eastern Ohio. These observations link by association the number of prescriptions by providers listed in the Medicare Part-D database, to opioid utilization and abuse in the general population.
The 25 providers who wrote the largest number of opioid prescriptions to Medicare beneficiaries in 2013 practice for the most part in the big cities, especially near Cincinnati. In contrast, Columbus has a surprisingly low opioid prescription rate for Medicare patients– a difference that begs to be understood. Continue reading “Is Prescribing Of Opioids To Medicare Patients Representative of Opioid Prescribing Generally?”