ArticleJMIR formative research2024
Occurrence of Stigmatizing Documentation Among Hospital Medicine Encounters With Opioid-Related Diagnosis Codes: Cohort Study.
Article in JMIR formative research, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Hospital-Based Clinicians' Knowledge and Practices Regarding Stigmatizing Language in Clinical Documentation: A Multicenter Survey.Journal of general internal medicine · 2026Article
- Article
- Beyond Keywords: A Qualitative Study of Context-Dependent Stigmatizing Language in Clinical Documentation from a Large, Multi-Payer Home Healthcare Agency.Home health care management & practice · 2025Article
- Sensitivity and Specificity of Natural Language Processing Systems for Identification of Hospitalized People Who Use Drugs.Open forum infectious diseases · 2025Article
- Article
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Authors and funding
6 authors.
Funding
Abstract
backgroundPhysician use of stigmatizing language in the clinical documentation of hospitalized adults with opioid use is common. However, patient factors associated with stigmatizing language in this setting remain poorly characterized.
objectiveThis study aimed to determine whether specific demographic factors and clinical outcomes are associated with the presence of stigmatizing language by physicians in the clinical documentation of encounters with opioid-related ICD-10 (International Statistical Classification of Diseases, Tenth Revision) codes.
methodsHospital encounters with one or more associated opioid-related ICD-10 admission diagnoses on the hospital medicine service during the 2020 calendar year were analyzed for the presence of stigmatizing language in history and physical and discharge summaries. Multivariable adjusted logistic regression models were used to determine associations of age, race, gender, medication for addiction treatment use, against medical advice discharge, homelessness, comorbid polysubstance use, comorbid psychiatric disorder, comorbid chronic pain, cost, and 30-day readmission with the presence of stigmatizing language.
resultsA total of 221 encounters were identified, of which 64 (29%) encounters had stigmatizing language present in physician documentation. Most stigmatizing language was due to use of "substance abuse" rather than the preferred term "substance use" (63/66 instances). Polysubstance use and homelessness were independently associated with the presence of stigmatizing language (adjusted odds ratio [aOR] 7.83; 95% CI 3.42-19.24 and aOR 2.44; 95% CI 1.03-5.90) when controlling for chronic pain and other covariates.
conclusionsAmong hospital medicine encounters with an opioid-related diagnosis, stigmatizing language by physicians in clinical documentation was common and independently associated with comorbid polysubstance use and homelessness.
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