Abstract
Objective The aim of the study is to evaluate the prevalence and factors associated with opioid
prescriptions to postpartum patients among TRICARE beneficiaries receiving care in
the civilian health care system versus a military health care facility.
Study Design We evaluated postpartum opioid prescriptions filled at discharge among patients insured
by TRICARE Prime/Prime Plus using the Military Health System Data Repository between
fiscal years 2010 to 2015. We included women aged 15 to 49 years old and excluded
abortive pregnancy outcomes and incomplete datasets. The primary outcome investigated
mode of delivery and demographics for those filling an opioid prescription. Secondary
outcomes compared prevalence of filled opioid prescription at discharge for postpartum
patients within civilian care and military care.
Results Of a total of 508,258 postpartum beneficiaries, those in civilian health care were
more likely to fill a discharge opioid prescription compared with those in military
health care (OR 3.9, 95% CI 3.8–3.99). Cesarean deliveries occurred less frequently
in military care (26%) compared with civilian care (30%), and forceps deliveries occurred
more frequently in military care (1.38%) compared with civilian care (0.75%). Women
identified as Asian race were least likely to fill an opioid prescription postpartum
(OR 0.79, 95% CI 0.75–0.83). Women aged 15 to 19 years had a lower odds of filling
an opioid prescription (OR 0.83, 95% CI 0.80–0.86). Women associated with a senior
officer rank were less likely to fill an opioid prescription postpartum (OR 0.83,
95% CI 0.73–0.91), while those associated with warrant officer rank were more likely
to fill an opioid prescription (OR 1.14, 95% CI 1.06–1.23).
Conclusion Our data indicates that women who received care in civilian facilities were more
likely to fill an opioid prescription at discharge when compared with military facilities.
Factors such as race and age were associated with opioid prescription at discharge.
This study highlights areas for improvement for potential further studies.
Key Points
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Opioid prescription patterns for postpartum women may vary across the country.
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Our study indicates postpartum patients in civilian care are more likely to fill opioids
postpartum.
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This study highlights a population which may have an improved opioid prescribing pattern.
Keywords
military health system - opioid prescription - postpartum - pain
