The Effect of an Inpatient Smoking Cessation Treatment Program on Hospital Readmissions and Length of Stay

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Abstract

BACKGROUND:

Most clinical research involving tobacco dependence treatment is related to outpatient interventions and focuses on health outcomes. Inpatient smoking cessation treatment has been found to be cost-effective in the Canadian healthcare system, but the finding's applicability to US health systems is unclear.

OBJECTIVE:

The objective of this study is to estimate the impact of an inpatient tobacco cessation treatment program on 30-day readmission rates and length of stay (LOS).

METHODS:

Participants were 28,994 patients admitted to the hospital between July 2012 and July 2014. Smokers were identified through the electronic medical records system and were offered cessation treatment. Program effects were estimated by using a difference-in-differences approach, comparing all smokers to all nonsmokers before versus after introduction of the program. Readmission rates were modeled by using probit regression; LOS was modeled by using truncated negative binomial regression. Models controlled for age, sex, race, payer, hospital department, severity of illness, and intensive care unit days.

RESULTS:

The hospital-initiated smoking cessation intervention had no significant effect on 30-day readmission rates or LOS. Other control variables had the expected signs and were statistically significant.

CONCLUSIONS:

The evaluation of an inpatient tobacco dependence treatment did not find significant short-term changes in healthcare utilization in the first 30 days after initial hospitalization.

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