{"id":4545,"date":"2015-12-07T10:45:25","date_gmt":"2015-12-07T15:45:25","guid":{"rendered":"http:\/\/www.khpi.org\/blog\/?p=4545"},"modified":"2017-02-13T14:02:09","modified_gmt":"2017-02-13T19:02:09","slug":"mapping-part-d-medicare-opioid-prescriptions-in-kentucky-by-county-and-zip-code","status":"publish","type":"post","link":"http:\/\/www.khpi.org\/blog\/mapping-part-d-medicare-opioid-prescriptions-in-kentucky-by-county-and-zip-code\/","title":{"rendered":"Mapping Part-D Medicare Opioid Prescriptions in Kentucky By County and Zip Code"},"content":{"rendered":"<p>In a\u00a0technical\u00a0test-posting<a href=\"http:\/\/www.khpi.org\/blog\/part-d-medicare-prescriptions-for-opioids-in-ky-by-zip-code-2013-test\/\" target=\"_blank\"> last week<\/a>, I reworked the dataset used by Medicare to show where prescriptions\u00a0of opioids to Part-D Medicare patients were written in Kentucky in 2013 by five-digit Zip Code. \u00a0I reworked the data to add the average number of opioid prescriptions written by\u00a0an\u00a0opioid prescriber in that zip code.\u00a0This supplements\u00a0Medicare&#8217;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. \u00a0In today&#8217;s\u00a0posting, I add a map of the same data broken down by Kentucky county. \u00a0Not surprisingly, significant geographic variation exists\u00a0in both maps\u00a0that is compatible both with public\u00a0perception of places where prescription drug abuse is prevalent, and locations\u00a0where individual prescriber outliers practice. This particular dataset is based on the principal\u00a0business address\u00a0of the prescriber, but I have shown that prescribing of opioids to Medicare patients <a href=\"http:\/\/www.khpi.org\/blog\/medicare-releases-on-line-application-to-map-opioid-prescriptions\/\" target=\"_blank\">correlates strongly<\/a> with prescribing\u00a0to all patients, and\u00a0that not unexpectedly, the location of the prescriber predicts\u00a0were the patients live. Descriptions of the underlying data and caveats for\u00a0its use are discussed in <a href=\"http:\/\/www.khpi.org\/blog\/category\/prescription-drug-abuse\/\" target=\"_blank\">earlier articles<\/a>.<\/p>\n<p><strong>Mapping by county:<\/strong><br \/>\nBelow 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.<iframe loading=\"lazy\" src=\"https:\/\/maps.espatial.com\/maps\/_CMS-Opioids-KY-Counties-2013\/pages\/map.jsp?geoMapId=137463&amp;TENANT_ID=138298&amp;lp=c\" width=\"600\" height=\"400\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/p>\n<p>View a larger version of <a href=\"https:\/\/maps.espatial.com\/maps\/_CMS-Opioids-KY-Counties-2013\/pages\/map.jsp?geoMapId=137463&amp;TENANT_ID=138298\">CMS Opioids KY Counties 2013<\/a> created with <a href=\"https:\/\/eSpatial.com\">eSpatial mapping software<\/a>.<\/p>\n<p><!--more--><\/p>\n<p><strong>Mapping by zip code:<\/strong><br \/>\nHere is the original map of opioid prescribing by five-digit zip codes.\u00a0Data is mapped for 329 Zip codes. For 38 of these, the number of prescriptions written is below the minimum\u00a0reported by CMS to protect patient confidentiality. On the map, these show up as uncolored areas. Recall that the zip code is that of the prescriber and not the patient.<br \/>\n<iframe loading=\"lazy\" src=\"https:\/\/maps.espatial.com\/maps\/_CMS-Opioids-KY-Zip-Codes-2013\/pages\/map.jsp?geoMapId=136897&amp;TENANT_ID=138298&amp;lp=c\" width=\"600\" height=\"400\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/p>\n<p>View a larger version of <a href=\"https:\/\/maps.espatial.com\/maps\/_CMS-Opioids-KY-Zip-Codes-2013\/pages\/map.jsp?geoMapId=136897&amp;TENANT_ID=138298\">CMS Opioids KY Zip Codes 2013<\/a> created with <a href=\"https:\/\/eSpatial.com\">eSpatial mapping software<\/a>.<\/p>\n<p><strong>Much more analysis is possible<\/strong>.<br \/>\nAs the map creator, I have the ability to filter the data or change the shaded category cutoffs displayed to better identify geographic outliers. \u00a0Here are two screen-shots demonstrating the ability to isolate the areas of highest opioid prescribing intensity.<\/p>\n<p><strong>Map of Kentucky Zip Codes where the average number of prescriptions per prescriber for opioids was greater than 200.<br \/>\n<a href=\"http:\/\/www.khpi.org\/blog\/wp-content\/uploads\/2015\/12\/av-rx-per-prescrib-1000.jpg\"><img loading=\"lazy\" class=\"alignleft wp-image-4549 size-full\" src=\"http:\/\/www.khpi.org\/blog\/wp-content\/uploads\/2015\/12\/av-rx-per-prescrib-575.jpg\" alt=\"av-rx-per-prescrib-575\" width=\"575\" height=\"263\" srcset=\"http:\/\/www.khpi.org\/blog\/wp-content\/uploads\/2015\/12\/av-rx-per-prescrib-575.jpg 575w, http:\/\/www.khpi.org\/blog\/wp-content\/uploads\/2015\/12\/av-rx-per-prescrib-575-150x69.jpg 150w, http:\/\/www.khpi.org\/blog\/wp-content\/uploads\/2015\/12\/av-rx-per-prescrib-575-300x137.jpg 300w, http:\/\/www.khpi.org\/blog\/wp-content\/uploads\/2015\/12\/av-rx-per-prescrib-575-500x229.jpg 500w\" sizes=\"(max-width: 575px) 85vw, 575px\" \/><\/a><\/strong><\/p>\n<p><strong>Map of Kentucky counties were opioid prescriptions exceeded 6% of all prescriptions to Medicare patients.<\/strong><a href=\"http:\/\/www.khpi.org\/blog\/wp-content\/uploads\/2015\/12\/county-rx-grthan-6percent-1000.jpg\"><img loading=\"lazy\" class=\"alignleft wp-image-4551 size-full\" src=\"http:\/\/www.khpi.org\/blog\/wp-content\/uploads\/2015\/12\/county-rx-grthan-6percent-575.jpg\" alt=\"county-rx-grthan-6percent-575\" width=\"575\" height=\"268\" srcset=\"http:\/\/www.khpi.org\/blog\/wp-content\/uploads\/2015\/12\/county-rx-grthan-6percent-575.jpg 575w, http:\/\/www.khpi.org\/blog\/wp-content\/uploads\/2015\/12\/county-rx-grthan-6percent-575-150x70.jpg 150w, http:\/\/www.khpi.org\/blog\/wp-content\/uploads\/2015\/12\/county-rx-grthan-6percent-575-300x140.jpg 300w, http:\/\/www.khpi.org\/blog\/wp-content\/uploads\/2015\/12\/county-rx-grthan-6percent-575-500x233.jpg 500w\" sizes=\"(max-width: 575px) 85vw, 575px\" \/><\/a><br \/>\nPlease help me learn how to use these and the related maps I hope to present. \u00a0What do these maps tell you? \u00a0I believe I have the ability to superimpose markers for the location of individual prescriber outliers, but I have only a few days more in my trial to learn how to do so. \u00a0 If this approach is\u00a0as useful as I think is should be, I may ask for your financial help to\u00a0purchase a year&#8217;s subscription to the software application for the Institute.<\/p>\n<p>Peter Hasselbacher, MD<br \/>\nPresident, KHPI<\/p>\n<div class=\"sharedaddy sd-sharing-enabled\"><div class=\"robots-nocontent sd-block sd-social sd-social-icon-text sd-sharing\"><h3 class=\"sd-title\">Share this:<\/h3><div class=\"sd-content\"><ul><li><a href=\"#\" class=\"sharing-anchor sd-button share-more\"><span>Share<\/span><\/a><\/li><li class=\"share-end\"><\/li><\/ul><div class=\"sharing-hidden\"><div class=\"inner\" style=\"display: none;\"><ul><li class=\"share-facebook\"><a rel=\"nofollow noopener noreferrer\" data-shared=\"sharing-facebook-4545\" class=\"share-facebook sd-button share-icon\" href=\"http:\/\/www.khpi.org\/blog\/mapping-part-d-medicare-opioid-prescriptions-in-kentucky-by-county-and-zip-code\/?share=facebook\" target=\"_blank\" title=\"Click to share on Facebook\" ><span>Facebook<\/span><\/a><\/li><li class=\"share-linkedin\"><a rel=\"nofollow noopener noreferrer\" data-shared=\"sharing-linkedin-4545\" class=\"share-linkedin sd-button share-icon\" href=\"http:\/\/www.khpi.org\/blog\/mapping-part-d-medicare-opioid-prescriptions-in-kentucky-by-county-and-zip-code\/?share=linkedin\" target=\"_blank\" title=\"Click to share on LinkedIn\" ><span>LinkedIn<\/span><\/a><\/li><li class=\"share-end\"><\/li><li class=\"share-twitter\"><a rel=\"nofollow noopener noreferrer\" data-shared=\"sharing-twitter-4545\" class=\"share-twitter sd-button share-icon\" href=\"http:\/\/www.khpi.org\/blog\/mapping-part-d-medicare-opioid-prescriptions-in-kentucky-by-county-and-zip-code\/?share=twitter\" target=\"_blank\" title=\"Click to share on Twitter\" ><span>Twitter<\/span><\/a><\/li><li class=\"share-email\"><a rel=\"nofollow noopener noreferrer\" data-shared=\"\" class=\"share-email sd-button share-icon\" href=\"mailto:?subject=%5BShared%20Post%5D%20Mapping%20Part-D%20Medicare%20Opioid%20Prescriptions%20in%20Kentucky%20By%20County%20and%20Zip%20Code&body=http%3A%2F%2Fwww.khpi.org%2Fblog%2Fmapping-part-d-medicare-opioid-prescriptions-in-kentucky-by-county-and-zip-code%2F&share=email\" target=\"_blank\" title=\"Click to email a link to a friend\" data-email-share-error-title=\"Do you have email set up?\" data-email-share-error-text=\"If you&#039;re having problems sharing via email, you might not have email set up for your browser. You may need to create a new email yourself.\" data-email-share-nonce=\"ce0ea0ff21\" data-email-share-track-url=\"http:\/\/www.khpi.org\/blog\/mapping-part-d-medicare-opioid-prescriptions-in-kentucky-by-county-and-zip-code\/?share=email\"><span>Email<\/span><\/a><\/li><li class=\"share-end\"><\/li><li class=\"share-end\"><\/li><\/ul><\/div><\/div><\/div><\/div><\/div>","protected":false},"excerpt":{"rendered":"<p>In a\u00a0technical\u00a0test-posting last week, I reworked the dataset used by Medicare to show where prescriptions\u00a0of opioids to Part-D Medicare patients were written in Kentucky in 2013 by five-digit Zip Code. \u00a0I reworked the data to add the average number of opioid prescriptions written by\u00a0an\u00a0opioid prescriber in that zip code.\u00a0This supplements\u00a0Medicare&#8217;s own calculation of the percent &hellip; <a href=\"http:\/\/www.khpi.org\/blog\/mapping-part-d-medicare-opioid-prescriptions-in-kentucky-by-county-and-zip-code\/\" class=\"more-link\">Continue reading<span class=\"screen-reader-text\"> &#8220;Mapping Part-D Medicare Opioid Prescriptions in Kentucky By County and Zip Code&#8221;<\/span><\/a><\/p>\n<div class=\"sharedaddy sd-sharing-enabled\"><div class=\"robots-nocontent sd-block sd-social sd-social-icon-text sd-sharing\"><h3 class=\"sd-title\">Share this:<\/h3><div class=\"sd-content\"><ul><li><a href=\"#\" class=\"sharing-anchor sd-button share-more\"><span>Share<\/span><\/a><\/li><li class=\"share-end\"><\/li><\/ul><div class=\"sharing-hidden\"><div class=\"inner\" style=\"display: none;\"><ul><li class=\"share-facebook\"><a rel=\"nofollow noopener noreferrer\" data-shared=\"sharing-facebook-4545\" class=\"share-facebook sd-button share-icon\" href=\"http:\/\/www.khpi.org\/blog\/mapping-part-d-medicare-opioid-prescriptions-in-kentucky-by-county-and-zip-code\/?share=facebook\" target=\"_blank\" title=\"Click to share on Facebook\" ><span>Facebook<\/span><\/a><\/li><li class=\"share-linkedin\"><a rel=\"nofollow noopener noreferrer\" data-shared=\"sharing-linkedin-4545\" class=\"share-linkedin sd-button share-icon\" href=\"http:\/\/www.khpi.org\/blog\/mapping-part-d-medicare-opioid-prescriptions-in-kentucky-by-county-and-zip-code\/?share=linkedin\" target=\"_blank\" title=\"Click to share on LinkedIn\" ><span>LinkedIn<\/span><\/a><\/li><li class=\"share-end\"><\/li><li class=\"share-twitter\"><a rel=\"nofollow noopener noreferrer\" data-shared=\"sharing-twitter-4545\" class=\"share-twitter sd-button share-icon\" href=\"http:\/\/www.khpi.org\/blog\/mapping-part-d-medicare-opioid-prescriptions-in-kentucky-by-county-and-zip-code\/?share=twitter\" target=\"_blank\" title=\"Click to share on Twitter\" ><span>Twitter<\/span><\/a><\/li><li class=\"share-email\"><a rel=\"nofollow noopener noreferrer\" data-shared=\"\" class=\"share-email sd-button share-icon\" href=\"mailto:?subject=%5BShared%20Post%5D%20Mapping%20Part-D%20Medicare%20Opioid%20Prescriptions%20in%20Kentucky%20By%20County%20and%20Zip%20Code&body=http%3A%2F%2Fwww.khpi.org%2Fblog%2Fmapping-part-d-medicare-opioid-prescriptions-in-kentucky-by-county-and-zip-code%2F&share=email\" target=\"_blank\" title=\"Click to email a link to a friend\" data-email-share-error-title=\"Do you have email set up?\" data-email-share-error-text=\"If you&#039;re having problems sharing via email, you might not have email set up for your browser. 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