Smoke-Free Policies and 30-Day Readmission Rates for Chronic Obstructive Pulmonary Disease

Sericea Stallings-Smith, Hanadi Y. Hamadi, Breck N. Peterson, Emma J.I. Apatu, Aaron C. Spaulding

Research output: Contribution to journalArticle

Abstract

Introduction: Previous evidence has shown that smoke-free policies reduce hospital admissions due to respiratory causes, but the impact on 30-day readmission has not been determined. As 25 states in the U.S. have not adopted comprehensive smoke-free legislation, it is likely that patients return to an environment that increases risk of a secondary event. The aim of this study is to investigate the impact of smoke-free policies on 30-day readmission rates for adults aged ≥65 years following hospitalization for chronic obstructive pulmonary disease in the U.S. Methods: Data from the U.S. Tobacco Control Laws Database, Centers for Medicare and Medicaid Services Hospital Readmissions Reduction Program, American Hospital Association, Area Health Resource File, and U.S. Census Bureau Current Population Survey were merged at the county level for years 2013–2016 and analyzed in 2018. Hierarchical Poisson regression models were utilized to calculate incidence rate ratios to determine the impact of full, partial, and no smoke-free policies on 30-day readmission rates after chronic obstructive pulmonary disease hospitalization. Results: Multivariable analysis adjusting for both county and hospital characteristics revealed that the presence of full (incidence rate ratio=0.81, 95% CI=0.76, 0.88) and partial (incidence rate ratio=0.87, 95% CI=0.81, 0.92) smoke-free policies were associated with fewer 30-day readmissions for chronic obstructive pulmonary disease–related hospitalizations when compared with counties with no smoke-free policy. Conclusions: The implementation of smoke-free policies is an effective measure for reducing 30-day readmissions following hospitalization due to chronic obstructive pulmonary disease, with stronger policies resulting in decreased risk. Efforts to reduce chronic obstructive pulmonary disease–related 30-day readmissions should include the implementation of smoke-free policies.

Original languageEnglish (US)
Pages (from-to)621-628
Number of pages8
JournalAmerican Journal of Preventive Medicine
Volume57
Issue number5
DOIs
StatePublished - Nov 2019

Fingerprint

Smoke-Free Policy
Chronic Obstructive Pulmonary Disease
Hospitalization
Incidence
American Hospital Association
County Hospitals
Centers for Medicare and Medicaid Services (U.S.)
Patient Readmission
Lung
Health Resources
Censuses
Legislation
Smoke
Tobacco
Databases

ASJC Scopus subject areas

  • Epidemiology
  • Public Health, Environmental and Occupational Health

Cite this

Smoke-Free Policies and 30-Day Readmission Rates for Chronic Obstructive Pulmonary Disease. / Stallings-Smith, Sericea; Hamadi, Hanadi Y.; Peterson, Breck N.; Apatu, Emma J.I.; Spaulding, Aaron C.

In: American Journal of Preventive Medicine, Vol. 57, No. 5, 11.2019, p. 621-628.

Research output: Contribution to journalArticle

Stallings-Smith, Sericea ; Hamadi, Hanadi Y. ; Peterson, Breck N. ; Apatu, Emma J.I. ; Spaulding, Aaron C. / Smoke-Free Policies and 30-Day Readmission Rates for Chronic Obstructive Pulmonary Disease. In: American Journal of Preventive Medicine. 2019 ; Vol. 57, No. 5. pp. 621-628.
@article{08c356faa6504b7eb69061afc79ce9db,
title = "Smoke-Free Policies and 30-Day Readmission Rates for Chronic Obstructive Pulmonary Disease",
abstract = "Introduction: Previous evidence has shown that smoke-free policies reduce hospital admissions due to respiratory causes, but the impact on 30-day readmission has not been determined. As 25 states in the U.S. have not adopted comprehensive smoke-free legislation, it is likely that patients return to an environment that increases risk of a secondary event. The aim of this study is to investigate the impact of smoke-free policies on 30-day readmission rates for adults aged ≥65 years following hospitalization for chronic obstructive pulmonary disease in the U.S. Methods: Data from the U.S. Tobacco Control Laws Database, Centers for Medicare and Medicaid Services Hospital Readmissions Reduction Program, American Hospital Association, Area Health Resource File, and U.S. Census Bureau Current Population Survey were merged at the county level for years 2013–2016 and analyzed in 2018. Hierarchical Poisson regression models were utilized to calculate incidence rate ratios to determine the impact of full, partial, and no smoke-free policies on 30-day readmission rates after chronic obstructive pulmonary disease hospitalization. Results: Multivariable analysis adjusting for both county and hospital characteristics revealed that the presence of full (incidence rate ratio=0.81, 95{\%} CI=0.76, 0.88) and partial (incidence rate ratio=0.87, 95{\%} CI=0.81, 0.92) smoke-free policies were associated with fewer 30-day readmissions for chronic obstructive pulmonary disease–related hospitalizations when compared with counties with no smoke-free policy. Conclusions: The implementation of smoke-free policies is an effective measure for reducing 30-day readmissions following hospitalization due to chronic obstructive pulmonary disease, with stronger policies resulting in decreased risk. Efforts to reduce chronic obstructive pulmonary disease–related 30-day readmissions should include the implementation of smoke-free policies.",
author = "Sericea Stallings-Smith and Hamadi, {Hanadi Y.} and Peterson, {Breck N.} and Apatu, {Emma J.I.} and Spaulding, {Aaron C.}",
year = "2019",
month = "11",
doi = "10.1016/j.amepre.2019.06.008",
language = "English (US)",
volume = "57",
pages = "621--628",
journal = "American Journal of Preventive Medicine",
issn = "0749-3797",
publisher = "Elsevier Inc.",
number = "5",

}

TY - JOUR

T1 - Smoke-Free Policies and 30-Day Readmission Rates for Chronic Obstructive Pulmonary Disease

AU - Stallings-Smith, Sericea

AU - Hamadi, Hanadi Y.

AU - Peterson, Breck N.

AU - Apatu, Emma J.I.

AU - Spaulding, Aaron C.

PY - 2019/11

Y1 - 2019/11

N2 - Introduction: Previous evidence has shown that smoke-free policies reduce hospital admissions due to respiratory causes, but the impact on 30-day readmission has not been determined. As 25 states in the U.S. have not adopted comprehensive smoke-free legislation, it is likely that patients return to an environment that increases risk of a secondary event. The aim of this study is to investigate the impact of smoke-free policies on 30-day readmission rates for adults aged ≥65 years following hospitalization for chronic obstructive pulmonary disease in the U.S. Methods: Data from the U.S. Tobacco Control Laws Database, Centers for Medicare and Medicaid Services Hospital Readmissions Reduction Program, American Hospital Association, Area Health Resource File, and U.S. Census Bureau Current Population Survey were merged at the county level for years 2013–2016 and analyzed in 2018. Hierarchical Poisson regression models were utilized to calculate incidence rate ratios to determine the impact of full, partial, and no smoke-free policies on 30-day readmission rates after chronic obstructive pulmonary disease hospitalization. Results: Multivariable analysis adjusting for both county and hospital characteristics revealed that the presence of full (incidence rate ratio=0.81, 95% CI=0.76, 0.88) and partial (incidence rate ratio=0.87, 95% CI=0.81, 0.92) smoke-free policies were associated with fewer 30-day readmissions for chronic obstructive pulmonary disease–related hospitalizations when compared with counties with no smoke-free policy. Conclusions: The implementation of smoke-free policies is an effective measure for reducing 30-day readmissions following hospitalization due to chronic obstructive pulmonary disease, with stronger policies resulting in decreased risk. Efforts to reduce chronic obstructive pulmonary disease–related 30-day readmissions should include the implementation of smoke-free policies.

AB - Introduction: Previous evidence has shown that smoke-free policies reduce hospital admissions due to respiratory causes, but the impact on 30-day readmission has not been determined. As 25 states in the U.S. have not adopted comprehensive smoke-free legislation, it is likely that patients return to an environment that increases risk of a secondary event. The aim of this study is to investigate the impact of smoke-free policies on 30-day readmission rates for adults aged ≥65 years following hospitalization for chronic obstructive pulmonary disease in the U.S. Methods: Data from the U.S. Tobacco Control Laws Database, Centers for Medicare and Medicaid Services Hospital Readmissions Reduction Program, American Hospital Association, Area Health Resource File, and U.S. Census Bureau Current Population Survey were merged at the county level for years 2013–2016 and analyzed in 2018. Hierarchical Poisson regression models were utilized to calculate incidence rate ratios to determine the impact of full, partial, and no smoke-free policies on 30-day readmission rates after chronic obstructive pulmonary disease hospitalization. Results: Multivariable analysis adjusting for both county and hospital characteristics revealed that the presence of full (incidence rate ratio=0.81, 95% CI=0.76, 0.88) and partial (incidence rate ratio=0.87, 95% CI=0.81, 0.92) smoke-free policies were associated with fewer 30-day readmissions for chronic obstructive pulmonary disease–related hospitalizations when compared with counties with no smoke-free policy. Conclusions: The implementation of smoke-free policies is an effective measure for reducing 30-day readmissions following hospitalization due to chronic obstructive pulmonary disease, with stronger policies resulting in decreased risk. Efforts to reduce chronic obstructive pulmonary disease–related 30-day readmissions should include the implementation of smoke-free policies.

UR - http://www.scopus.com/inward/record.url?scp=85072691774&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85072691774&partnerID=8YFLogxK

U2 - 10.1016/j.amepre.2019.06.008

DO - 10.1016/j.amepre.2019.06.008

M3 - Article

C2 - 31564604

AN - SCOPUS:85072691774

VL - 57

SP - 621

EP - 628

JO - American Journal of Preventive Medicine

JF - American Journal of Preventive Medicine

SN - 0749-3797

IS - 5

ER -