A Prospective Micro-Costing Analysis of a Novel Opioid Overdose Diversion Center

Abstract

Importance: The opioid epidemic continues to be an ongoing public health threat which has resulted in an enormous death toll and has placed significant burden on multiple aspects of our public health system. Responding to overdoses requires ample resources from our emergency medical care system, but many current hospital systems are not resourced to provide wrap around care to promote ongoing recovery to overdose patients. Multiple social service and public service organizations have collaborated to develop a novel opioid overdose diversion center, the ORCA center, to dually help reduce the resource burden on King County's medical system and deliver tailored services to people with Opioid Use Disorder (OUD) who experience overdose. This innovative clinic will not only provide immediate medical care to overdose patients but will engage with patients to identify key community resources and medication for OUD which will help them achieve recovery. However, the costs associated with the provision of this care are currently unknown. Objective: To determine the costs associated with this innovative opioid overdose diversion clinic. Design: A prospective micro-costing analysis. Setting: Seattle, WA Main Outcome and Measures: Total cost and cost per patient over three years of service delivery. Results: Total estimated costs for the ORCA Center range from $8,132,950.29 in year one to $6,297,818.10 in year three, with per-patient costs declining from $6,898.18 in year one to $2,670.83 in year three. Conclusion: Fixed costs for the development of a novel opioid overdose center result in a concentration of costs in the initial development year of the ORCA center. However, even with an anticipated increase in the service population, total costs per year and costs per patient are expected to decrease in subsequent years. Future cost analyses of the ORCA center are required to further refine cost parameters associated with this novel opioid overdose diversion center.