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Baliunas D, Selby P, de Oliveira C, et al. Primary care-based smoking cessation treatment and subsequent healthcare service utilisation: a matched cohort study of smokers using linked administrative healthcare data. Tob Control. 2021;doi: 10.1136/tobaccocontrol-2021-056522.
Baliunas, D., Selby, P., de Oliveira, C., Kurdyak, P., Rosella, L., Zawertailo, L., Fu, L., & Sutradhar, R. (2021). Primary care-based smoking cessation treatment and subsequent healthcare service utilisation: a matched cohort study of smokers using linked administrative healthcare data. Tobacco control, . https://doi.org/10.1136/tobaccocontrol-2021-056522
Baliunas, Dolly, et al. "Primary care-based smoking cessation treatment and subsequent healthcare service utilisation: a matched cohort study of smokers using linked administrative healthcare data." Tobacco control vol. (2021). doi: https://doi.org/10.1136/tobaccocontrol-2021-056522
Baliunas D, Selby P, de Oliveira C, Kurdyak P, Rosella L, Zawertailo L, Fu L, Sutradhar R. Primary care-based smoking cessation treatment and subsequent healthcare service utilisation: a matched cohort study of smokers using linked administrative healthcare data. Tob Control. 2021 Jun 03; doi: 10.1136/tobaccocontrol-2021-056522. Epub 2021 Jun 03. PMID: 34083493.
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Tob Control. 2021 Jun 03; doi: 10.1136/tobaccocontrol-2021-056522. Epub 2021 Jun 03.

Primary care-based smoking cessation treatment and subsequent healthcare service utilisation: a matched cohort study of smokers using linked administrative healthcare data.

Tobacco control

Dolly Baliunas, Peter Selby, Claire de Oliveira, Paul Kurdyak, Laura Rosella, Laurie Zawertailo, Longdi Fu, Rinku Sutradhar

Affiliations

  1. School of Public Health, The University of Queensland, Herston, Queensland, Australia [email protected].
  2. Clinical Research Addictions, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
  3. Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
  4. Nicotine Dependence Service, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
  5. Department of Psychiatry, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
  6. Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada.
  7. Centre for Health Economics and Hull York Medical School, University of York, York, UK.
  8. Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
  9. ICES, Toronto, Ontario, Canada.
  10. Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.
  11. Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
  12. Department of Pharmacology and Toxicology, University of Toronto Faculty of Medicine, Toronto, Ontario, Canada.
  13. Division of Biostatistics, University of Toronto, Toronto, Ontario, Canada.

PMID: 34083493 DOI: 10.1136/tobaccocontrol-2021-056522

Abstract

BACKGROUND: No research has assessed the individual-level impact of smoking cessation treatment delivered within a general primary care patient population on multiple forms of subsequent healthcare service use.

OBJECTIVE: We aimed to compare the rate of outpatient visits, emergency department (ED) visits and hospitalisations during a 5-year follow-up period among smokers who had and had not accessed a smoking cessation treatment programme.

METHODS: The study was a retrospective matched cohort study using linked demographic and administrative healthcare databases in Ontario, Canada. 9951 patients who accessed smoking cessation services between July 2011 and December 2012 were matched to a smoker who did not access services, obtained from the Canadian Community Health Survey, using a combination of hard matching and propensity score matching. Outcomes were rates of healthcare service use from index date (programme enrolment or survey response) to March 2017.

RESULTS: After controlling for potential confounders, patients in the overall treatment cohort had modestly greater rates of the outcomes: outpatient visits (rate ratio (RR) 1.10, 95% CI: 1.06 to 1.14), ED visits (RR 1.08, 95% CI: 1.03 to 1.13) and hospitalisations (RR 1.09, 95% CI: 1.02 to 1.18). Effect modification of the association between smoking cessation treatment and healthcare service use by prevalent comorbidity was found for outpatient visits (p=0.006), and hospitalisations (p=0.050), but not ED visits.

CONCLUSIONS: Patients who enrolled in smoking cessation treatment offered through primary care clinics in Ontario displayed a modest but significantly greater rate of outpatient visits, ED visits and hospitalisations over a 5-year follow-up period.

© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Keywords: cessation; health services; primary health care

Conflict of interest statement

Competing interests: DB reports receiving grant funding in the past 5 years from Pfizer, Ontario Ministry of Health and Long-Term Care, Canadian Institutes of Health Research (CIHR) and the Canadian C

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