TY - JOUR
T1 - Association between smoking cessation and post-hospitalization healthcare costs
T2 - A matched cohort analysis
AU - Nolan, Margaret B.
AU - Borah, Bijan J.
AU - Moriarty, James P.
AU - Warner, David O.
N1 - Funding Information:
The underlying study was funded by grant RC-2012-0001 from Clearway Minnesota. The study sponsor had no role in the study design, collection, analysis, or interpretation of the data, the writing of the report, or the decision to submit the report for publication.
Publisher Copyright:
© 2019 The Author(s).
PY - 2019/12/2
Y1 - 2019/12/2
N2 - Background: The potential economic benefit in terms of reduced healthcare costs when patients quit smoking after hospital discharge has not been directly measured. The aim of this study was to compare the costs for hospital admission and six-month follow-up for a cohort of patients who self-reported abstinence from cigarettes at 6 months after hospital discharge and a matched group of patients who reported continued smoking. Materials and methods: This was a secondary analysis of a recent population-based clinical trial cohort (ClinicalTrials.gov ID: NCT01575145), with cohort membership determined by self-reported 7 day point prevalence abstinence at 6 months after the index hospital discharge. Participants were admitted to Mayo Clinic Hospital, Rochester, MN, between May 5, 2012 and August 10, 2014 for any indication and lived in the areas covered by postal codes included in Olmsted County, MN. Propensity score matching was used to control for differences between groups other than smoking status, and any residual imbalance was adjusted through generalized linear model with gamma distribution for cost and log-link transformation. Results: Of 600 patients enrolled in the clinical trial, 144 could be contacted and self-reported 7 day point prevalence abstinence at 6 months after hospital discharge. Of these patients, 99 were successfully matched for this analysis. The cost for the index hospitalization was significantly greater in patients who abstained compared to those that did not abstain (mean difference of $3042, higher for abstainers, 95% CI $170 to $5913, P = 0.038). However, there was no difference between mean 6-month follow-up costs, number of inpatient hospitalizations, or number of emergency room visits for abstainers versus non-Abstainers. Conclusion: There was no evidence to support the hypothesis that abstinence at 6 months after hospital discharge is associated with a decrease in health care costs or utilization over the first 6 months after hospital discharge.
AB - Background: The potential economic benefit in terms of reduced healthcare costs when patients quit smoking after hospital discharge has not been directly measured. The aim of this study was to compare the costs for hospital admission and six-month follow-up for a cohort of patients who self-reported abstinence from cigarettes at 6 months after hospital discharge and a matched group of patients who reported continued smoking. Materials and methods: This was a secondary analysis of a recent population-based clinical trial cohort (ClinicalTrials.gov ID: NCT01575145), with cohort membership determined by self-reported 7 day point prevalence abstinence at 6 months after the index hospital discharge. Participants were admitted to Mayo Clinic Hospital, Rochester, MN, between May 5, 2012 and August 10, 2014 for any indication and lived in the areas covered by postal codes included in Olmsted County, MN. Propensity score matching was used to control for differences between groups other than smoking status, and any residual imbalance was adjusted through generalized linear model with gamma distribution for cost and log-link transformation. Results: Of 600 patients enrolled in the clinical trial, 144 could be contacted and self-reported 7 day point prevalence abstinence at 6 months after hospital discharge. Of these patients, 99 were successfully matched for this analysis. The cost for the index hospitalization was significantly greater in patients who abstained compared to those that did not abstain (mean difference of $3042, higher for abstainers, 95% CI $170 to $5913, P = 0.038). However, there was no difference between mean 6-month follow-up costs, number of inpatient hospitalizations, or number of emergency room visits for abstainers versus non-Abstainers. Conclusion: There was no evidence to support the hypothesis that abstinence at 6 months after hospital discharge is associated with a decrease in health care costs or utilization over the first 6 months after hospital discharge.
KW - Healthcare costs
KW - Hospital costs
KW - Smoking
KW - Smoking cessation
UR - http://www.scopus.com/inward/record.url?scp=85076007619&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85076007619&partnerID=8YFLogxK
U2 - 10.1186/s12913-019-4777-7
DO - 10.1186/s12913-019-4777-7
M3 - Article
C2 - 31791307
AN - SCOPUS:85076007619
SN - 1472-6963
VL - 19
JO - BMC health services research
JF - BMC health services research
IS - 1
M1 - 924
ER -