Engaging Opioid Overdose Survivors: Impact of Peer Recovery Specialists on Patient Utilization and Cost

Abstract

Peer recovery specialists play a key role in addressing the current opioid crisis. The Opioid Survivor Outreach Program (OSOP) peer recovery specialist intervention was designed to support opioid overdose survivors. In this program, patients are connected with a peer recovery specialist and are provided connection to treatment, support services, and harm reduction tools. This study was a quasi-experimental, mixed-methods approach to evaluate the impact of OSOP on opioid-related and all-cause hospital visits and acute care cost avoidance. Chapter 1 focuses in on evaluating impact of OSOP on hospital visits while Chapter 2 evaluates the impact on cost avoidance through the assessment of hospital charges. The third chapter leverages in-depth interviews from OSOP peer recovery specialists, nurses, and physicians to allow for a more comprehensive understanding of the program’s efficacy. Narrative content analysis was used to analyze the interview data from 11 participants. A historical control group was selected through propensity score matching to compare hospital visit and charges data with a study population at four study setting hospitals. A negative binomial regression was used to assess the differences in hospital visits among the groups while two sample t-test was used to analyze differences in hospital charges. OSOP was found to reduce expected opioid-related visits by 32.5% in the pre and post-enrollment OSOP study group, as well as all-cause hospital visits. Opioid-related hospital visits result in $703 more in charges when compared to non-opioid related visits. When analyzing gross charges and programmatic costs, the OSOP program allows the healthcare system to avoid$1.1M in opioid-related hospital charges over one year and $770K in all-cause hospital charges. The findings suggest that the OSOP program is an intervention that assists patients in seeking substance use and supportive services while reducing acute hospital utilization and cost. Interviews from participants confirmed that a peer recovery specialist lived experiences encourage patients to enroll in OSOP. Peers have a command of the treatment ecosystem to effectively advocate and link patients to care. Further, insights from providers give other health institutions considerations on how to build a successful OSOP program in the emergency department environment