Objective: Traditional public health surveillance of nonfatal opioid overdose relies on emergency department (ED) billing data, which can be delayed substantially. We compared the timeliness of 2 new data sources for rapid drug overdose surveillance—emergency medical services (EMS) and syndromic surveillance—with ED billing data. Methods: We used data on nonfatal opioid overdoses in Kentucky captured in EMS, syndromic surveillance, and ED billing systems during 2018-2019. We evaluated the time-series relationships between EMS and ED billing data and syndromic surveillance and ED billing data by calculating cross-correlation functions, controlling for influences of autocorrelations. A case example demonstrates the usefulness of EMS and syndromic surveillance data to monitor rapid changes in opioid overdose encounters in Kentucky during the COVID-19 epidemic. Results: EMS and syndromic surveillance data showed moderate-to-strong correlation with ED billing data on a lag of 0 (r = 0.694; 95% CI, 0.579-0.782; t = 9.73; df = 101; P <.001; and r = 0.656; 95% CI, 0.530-0.754; t = 8.73; df = 101; P <.001; respectively) at the week-aggregated level. After the COVID-19 emergency declaration, EMS and syndromic surveillance time series had steep increases in April and May 2020, followed by declines from June through September 2020. The ED billing data were available for analysis 3 months after the end of a calendar quarter but closely followed the trends identified by the EMS and syndromic surveillance data. Conclusion: Data from EMS and syndromic surveillance systems can be reliably used to monitor nonfatal opioid overdose trends in Kentucky in near–real time to inform timely public health response.
|Journal||Public Health Reports|
|State||Published - Nov 2021|
Bibliographical noteFunding Information:
The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This research project was funded as part of the Centers for Disease Control and Prevention’s Enhanced State Opioid Overdose Surveillance program (funding no. 5NU17CE924880).
The authors thank the Kentucky Board of Emergency Medical Services, the Kentucky Department for Public Health, and the Kentucky Office of Health Data and Analytics teams for providing support for this study. The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This research project was funded as part of the Centers for Disease Control and Prevention’s Enhanced State Opioid Overdose Surveillance program (funding no. 5NU17CE924880).
© 2021, Association of Schools and Programs of Public Health.
- opioid overdose
- syndromic surveillance
- time-series analysis
ASJC Scopus subject areas
- Public Health, Environmental and Occupational Health