The Journal of the Arkansas Medical Society Med Journal Feb 2019 Final 2 | Page 15

Figure 2. Neonatal Abstinence Syndrome Diagnoses Per 1,000 Hospital
Births, Arkansas Residents, 2010-2014*
About four out of every 1,000
white babies were diagnosed
with NAS in 2014, compared to
about one out of every 1,000
among non-whites.
tween women with different types of insurance.
In 2014, the rate of NAS diagnosis was 4.7 per
1,000 births among women on Medicaid com-
pared with 1.5 per 1,000 births among women
with private insurance (table 1).
The rate of NAS diagnoses also varied by
county. About half of the counties in Arkansas
did not report a single case of NAS from 2010 to
2014. On the other hand, there are some coun-
ties where up to 13 out of every 1,000 babies are
diagnosed with NAS (figure 2).
*Does not include births to Arkansas mothers occurring in out-of-state hospitals
Source: ADH Hospital Discharge Data System
the Census Bureau to determine prescriptions
filled per capita.
Results
The rate of NAS diagnoses per 1,000 live
births increased from 0.3 in 2000 to 3.2 in 2014
(Figure 1). Babies diagnosed with NAS had longer
hospital stays and higher charges than babies
who were not diagnosed with NAS. In 2014, the
median length of stay for babies diagnosed with
NAS was 11 compared to two days for babies
who were not diagnosed with NAS. That same
year, the median charges for a baby diagnosed
with NAS were $31,413, compared to $3,533 for
babies who were not diagnosed with NAS.
In 2014, the rate of NAS diagnosis was
higher among whites, non-Hispanics, and pa-
tients covered by Medicaid. The rate of NAS di-
agnosis was nearly three times higher in whites
than in non-Whites. About four out of every
1,000 white babies were diagnosed with NAS in
2014, compared to about one out of every 1,000
among non-whites. Similarly, non-Hispanics had
higher rates than Hispanics, 3.4 and 2.5 per
1,000 births, respectively. The largest dispari-
ties in rates of NAS diagnosis were found be-
In 2014, 899,640 opioid prescriptions were
filled by Arkansas women between the ages
of 15 and 49. Opioid prescriptions filled per
capita increased with age. The lowest rate was
0.36 prescriptions per capita, which was found
among women aged 15-19. The highest rate
was 2.11 prescriptions per capita which was
found among women aged 45-49. Women aged
25 years or more, who account for 59.3% of all
births, filled one or more opioid prescriptions per
capita in 2014 (figure 3).
Discussion
Hospital discharge data indicates a large
increase in the rate of NAS since 2000. During
this period, whites, non-Hispanics, and people
covered by Medicaid had above average rates
Table 1. Neonatal Abstinence Syndrome Diagnoses: Demographic Characteristics and Insurance, Arkansas Residents, 2014*
Race***
Ethnicity
Insurance
Number Percent** Rate per 1,000
100 91.7% 4.1
Non-white 9 8.3% 1.1
Hispanic 12 11.0% 2.5
Non-Hispanic 95 87.2% 3.4
Medicaid 83 76.2% 4.7
Private 15 14.8 1.5
Other or Unknown 11 10.1 2.1
White
*Totals vary due to missing values
**Percentages may not add up to 100 due to missing values
Source: ADH Hospital Discharge Data System
***Non-whites merged into a single category to ensure confidentiality
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