Date of Award

1-1-2024

Document Type

Thesis

Degree Name

Master of Public Health (MPH)

Department

School of Public Health

First Advisor

Julie R. Gaither

Second Advisor

Mayur M. Desai

Abstract

Importance: It is not yet known how many adolescents are readmitted within six months in the U.S. following a non-fatal overdose and the risk factors associated with all-cause readmission. Objective: To examine the risk of 6-month readmission following hospitalization for a non-fatal drug overdose among adolescents and the risk factors for readmission. Design, Setting, and Participants: This retrospective chart analysis utilized the Nationwide Readmission Database (NRD) from 2016 to 2020 to identify nonfatal overdose readmissions among adolescents aged 11 to 19. Exposures: Non-fatal prescription and illicit drug overdose. Main Outcome Measures: The study used weighted state-level discharge data to derive nationally representative estimates. The frequency of overdoses for each drug was determined annually to identify trends over time. Descriptive statistics were used to characterize the sample. Multivariable logistic regression was utilized to identify factors associated with readmission following a non-fatal overdose, controlling for potential confounders. Results: The study included 26,318 individuals, with 14,272 [54.2%] female adolescents in the sample. There were 5,456 [20.7%] 11–14-year-olds in the sample, and 13,043 [49.6%] of adolescents had a mood disorder. 4,514 [17.2%] adolescents were readmitted within 6 months for any cause. Having a behavioral disorder and poisoning by other opioids increased the odds of 6-month all-cause readmission by 1.23 [95% CI 1.04-1.46)] and [1.42, 95% CI 1.11-1.782, respectively. Having a mood or substance use disorder did not increase the odds of all-cause readmission. The year with the most index events was 2017, while the lowest was 2020. There has been an increase in synthetic opioids in non-fatal overdose cases. Conclusions and Relevance: This serial cross-sectional study of adolescents previously admitted for non-fatal overdose revealed an association with other opioids and unspecified narcotic poisoning, affirming the link between opioid use and increased readmission odds among adolescents. Behavioral and anxiety disorders were associated with increased odds of readmission. Medicaid beneficiaries also had higher odds of readmission, underscoring the need for targeted interventions among this population. The increase in synthetic opioids confirms the findings of previous literature and suggests the need for more interventions targeted toward synthetic opioid overdose prevention.

Comments

This thesis is restricted to Yale network users only. It will be made publicly available on 05/07/2026

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