Journal article
Hospital Costs Associated with Smoking in Veterans Undergoing General Surgery
Journal of the American College of Surgeons, Vol.214(6), pp.901-908.e1
06/2012
DOI: 10.1016/j.jamcollsurg.2012.01.056
PMID: 22502993
Abstract
Approximately 30% of patients undergoing elective general surgery smoke cigarettes. The association between smoking status and hospital costs in general surgery patients is unknown. The objectives of this study were to compare total inpatient costs in current smokers, former smokers, and never smokers undergoing general surgical procedures in Veterans Affairs (VA) hospitals; and to determine whether the relationship between smoking and cost is mediated by postoperative complications.
Patients undergoing general surgery during the period of October 1, 2005 to September 30, 2006 were identified in the VA Surgical Quality Improvement Program (VASQIP) data set. Inpatient costs were extracted from the VA Decision Support System (DSS). Relative surgical costs (incurred during index hospitalization and within 30 days of operation) for current and former smokers relative to never smokers, and possible mediators of the association between smoking status and cost were estimated using generalized linear regression models. Models were adjusted for preoperative and operative variables, accounting for clustering of costs at the hospital level.
Of the 14,853 general surgical patients, 34% were current smokers, 39% were former smokers, and 27% were never smokers. After controlling for patient covariates, current smokers had significantly higher costs compared with never smokers: relative cost was 1.04 (95% Cl 1.00 to 1.07; p = 0.04); relative costs for former smokers did not differ significantly from those of never smokers: 1.02 (95% Cl 0.99 to 1.06; p = 0.14). The relationship between smoking and hospital costs for current smokers was partially mediated by postoperative respiratory complications.
These findings complement emerging evidence recommending effective smoking cessation programs in general surgical patients and provide an estimate of the potential savings that could be accrued during the preoperative period.
Details
- Title: Subtitle
- Hospital Costs Associated with Smoking in Veterans Undergoing General Surgery
- Creators
- Aparna S Kamath - The Center for Comprehensive Access & Delivery Research and Evaluation (CADRE) at the Iowa City VA Healthcare System, Iowa City, IAMary Vaughan Sarrazin - The Center for Comprehensive Access & Delivery Research and Evaluation (CADRE) at the Iowa City VA Healthcare System, Iowa City, IAMark W Vander Weg - The Center for Comprehensive Access & Delivery Research and Evaluation (CADRE) at the Iowa City VA Healthcare System, Iowa City, IAXueya Cai - Department of Biostatistics and Computational Biology (SMD), University of Rochester School of Medicine and Dentistry, Rochester, NYJoseph Cullen - The Center for Comprehensive Access & Delivery Research and Evaluation (CADRE) at the Iowa City VA Healthcare System, Iowa City, IADavid A Katz - The Center for Comprehensive Access & Delivery Research and Evaluation (CADRE) at the Iowa City VA Healthcare System, Iowa City, IA
- Resource Type
- Journal article
- Publication Details
- Journal of the American College of Surgeons, Vol.214(6), pp.901-908.e1
- DOI
- 10.1016/j.jamcollsurg.2012.01.056
- PMID
- 22502993
- NLM abbreviation
- J Am Coll Surg
- ISSN
- 1072-7515
- eISSN
- 1879-1190
- Publisher
- Elsevier Inc
- Grant note
- HFP 04-149 / Comprehensive Access & Delivery Research and Evaluation (CADRE) Center
- Language
- English
- Date published
- 06/2012
- Academic Unit
- Health Management and Policy; Epidemiology; Psychological and Brain Sciences; Surgery; Radiation Oncology; Injury Prevention Research Center; General Internal Medicine; Community and Behavioral Health; Internal Medicine
- Record Identifier
- 9984051558202771
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