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

Article


Baliunas, Dolly, Selby, Peter, de Oliveira, Claire, Kurdyak, Paul, Rosella, Laura, Zawertailo, Laurie, Fu, Longdi and Sutradhar, Rinku. 2023. "Primary care-based smoking cessation treatment and subsequent healthcare service utilisation: a matched cohort study of smokers using linked administrative healthcare data." Tobacco Control. 32 (1), pp. 72-79. https://doi.org/10.1136/tobaccocontrol-2021-056522
Article Title

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

ERA Journal ID13806
Article CategoryArticle
AuthorsBaliunas, Dolly, Selby, Peter, de Oliveira, Claire, Kurdyak, Paul, Rosella, Laura, Zawertailo, Laurie, Fu, Longdi and Sutradhar, Rinku
Journal TitleTobacco Control
Journal Citation32 (1), pp. 72-79
Number of Pages8
Year2023
PublisherBMJ
Place of PublicationUnited Kingdom
ISSN0964-4563
Digital Object Identifier (DOI)https://doi.org/10.1136/tobaccocontrol-2021-056522
Web Address (URL)https://tobaccocontrol.bmj.com/content/32/1/72
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.

KeywordsHumans
ANZSRC Field of Research 2020420308. Health informatics and information systems
Byline AffiliationsUniversity of Queensland
Centre for Addiction and Mental Health, Canada
University of Toronto, Canada
University of York, United Kingdom
International Credential Evaluation Service (ICES), Canada
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