Withdrawal Syndrome in Newborns Hal Johnson State Epidemiology and - PowerPoint PPT Presentation

Withdrawal Syndrome in Newborns Hal Johnson State Epidemiology and Outcome Workgroup Meeting November 8, 2011

ICD-9 Code 779 Other and ill-defined conditions originating in the perinatal period – 779.5 Drug withdrawal syndrome in newborn – Drug withdrawal syndrome in infant of dependent mother – Excludes: fetal alcohol syndrome (760.71) • No code for type of drug • No way (in public data set) to connect to mother’s record

Trend in Newborn Withdrawal Syndrome Diagnoses, 2005-2010 1600 1355 1200 Number of diagnoses 433% 800 400 254 0 2005 2006 2007 2008 2009 2010

county_name 2005 2006 2007 2008 2009 2010 county_name 2005 2006 2007 2008 2009 2010 Alachua 1 2 5 6 9 13 Lee 8 14 11 26 54 73 Baker 2 3 1 3 7 Leon 2 6 2 6 Bay 3 2 1 5 7 4 Levy 1 1 4 4 4 Bradford 1 2 5 3 7 Liberty Brevard 21 10 26 43 47 68 Madison 1 2 1 Broward 11 12 35 36 38 65 Manatee 7 13 2 14 17 27 Calhoun Marion 2 8 9 12 16 23 Charlotte 4 1 3 14 13 29 Martin 1 4 3 2 1 Citrus 1 2 7 12 Miami-Dade 9 8 10 13 17 21 Clay 3 8 11 8 18 14 Monroe 1 1 2 Collier 12 12 19 25 32 29 Nassau 3 2 4 6 3 7 Columbia 2 2 3 4 7 15 Okaloosa 8 7 6 8 14 20 DeSoto 1 4 1 7 Okeechobee 2 1 3 5 3 Dixie 2 2 6 7 Orange 13 18 18 39 34 63 Duval 24 37 53 36 85 113 Osceola 3 1 3 7 7 5 Escambia 15 20 26 32 42 27 Palm Beach 12 15 15 29 34 26 Flagler 1 1 2 4 7 Pasco 5 20 36 50 75 147 Franklin 1 Pinellas 22 32 38 70 114 153 Gadsden 1 1 Polk 9 10 11 10 9 11 Gilchrist 1 1 1 3 Putnam 1 1 3 14 14 Glades Saint Johns 1 3 9 3 17 13 Gulf 1 1 Saint Lucie 3 5 4 9 10 11 Hamilton 1 1 Santa Rosa 2 6 14 6 7 10 Hardee 1 1 1 Sarasota 8 5 11 15 40 74 Hendry 2 3 1 2 1 1 Seminole 3 4 2 10 9 15 Hernando 2 8 13 14 30 39 Sumter 2 1 3 Highlands 1 5 1 2 Suwannee 1 3 9 9 Hillsborough 13 28 19 22 31 66 Taylor 1 1 Holmes Union 1 2 6 Indian River 4 1 1 3 10 5 Volusia 6 7 11 25 34 45 Jackson 1 1 Wakulla 1 2 3 Jefferson Walton 2 5 6 3 4 Lafayette Washington 3 Lake 1 4 5 2 5 10 FLORIDA 123 158 236 268 405 1355

Counties with 10+ cases in 3+ years county_name 2005 2006 2007 2008 2009 2010 Brevard 21 10 26 43 47 68 Broward 11 12 35 36 38 65 Charlotte 4 1 3 14 13 29 Clay 3 8 11 8 18 14 Collier 12 12 19 25 32 29 Duval 24 37 53 36 85 113 Escambia 15 20 26 32 42 27 Hernando 2 8 13 14 30 39 Hillsborough 13 28 19 22 31 66 Lee 8 14 11 26 54 73 Manatee 7 13 2 14 17 27 Marion 2 8 9 12 16 23 Miami-Dade 9 8 10 13 17 21 Orange 13 18 18 39 34 63 Palm Beach 12 15 15 29 34 26 Pasco 5 20 36 50 75 147 Pinellas 22 32 38 70 114 153 Polk 9 10 11 10 9 11 Sarasota 8 5 11 15 40 74 Volusia 6 7 11 25 34 45

Holmes J a c k s o n Okaloosa N a s s a u G a d s d e n Escambia H a m i l t o n C a l h o u n L e o n M a d i s o n B a y D u v a l B a k e r L i b e r t y W a k u l l a S u w a n n e e T a y l o r U n i o n S t . F r a n k l i n C l a y G u l f J o h n s G i l c h r i s t A l a c h u a P u t n a m D i x i e F l a g l e r L e v y M a r i o n Counties with 10 or more Volusia C i t r u s L a k e cases of newborn withdrawal S e m i n o l e S u m t e r H e r n a n d o O r a n g e syndrome in at least 3 of the P a s c o O s c e o l a Hillsborough P o l k past 6 years I n d i a n R i v e r P i n e l l a s H a r d e e M a n a t e e S t . L u c i e H i g h l a n d s D e S o t o S a r a s o t a M a r t i n Charlotte Rate per 100,000 live births G l a d e s Palm Beach H e n d r y L e e 1,000+ Broward C o l l i e r 443-999 Dade <443 Florida: 443/100K

Newborn Withdrawal Syndrome Tends by County 100% 80% Other Charlotte 60% Hernando 40% 33% Sarasota 16% Pasco 20% Pinellas 0% 2005 2006 2007 2008 2009 2010

Holmes J a c k s o n Okaloosa N a s s a u G a d s d e n Escambia H a m i l t o n C a l h o u n L e o n M a d i s o n B a y D u v a l B a k e r L i b e r t y W a k u l l a S u w a n n e e T a y l o r U n i o n S t . F r a n k l i n C l a y G u l f J o h n s G i l c h r i s t A l a c h u a P u t n a m D i x i e F l a g l e r L e v y M a r i o n Volusia Counties Ranked High on Three or More of the C i t r u s L a k e S e m i n o l e S u m t e r Following Indicators: H e r n a n d o O r a n g e • Rate of Prescription Opiate Deaths Pasco • Rate of Prescription Benzo Deaths O s c e o l a Hillsborough P o l k • Rate of Overdose ED Visits/Hospitalizations I n d i a n R i v e r P i n e l l a s • Pain Clinics per 100,000 Manatee H a r d e e S t . L u c i e • Treatment Admissions for Prescription Drugs H i g h l a n d s D e S o t o Sarasota M a r t i n Charlotte G l a d e s Palm Beach Number of high indicators: H e n d r y L e e Broward C o l l i e r 5 Dade 4 3