RT Journal Article
SR Electronic
T1 Primary care-based smoking cessation treatment and subsequent healthcare service utilisation: a matched cohort study of smokers using linked administrative healthcare data
JF Tobacco Control
JO Tob Control
FD BMJ Publishing Group Ltd
SP 72
OP 79
DO 10.1136/tobaccocontrol-2021-056522
VO 32
IS 1
A1 Dolly Baliunas
A1 Peter Selby
A1 Claire de Oliveira
A1 Paul Kurdyak
A1 Laura Rosella
A1 Laurie Zawertailo
A1 Longdi Fu
A1 Rinku Sutradhar
YR 2023
UL http://tobaccocontrol.bmj.com/content/32/1/72.abstract
AB 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.The data set from this study, composed of STOP programme data and ICES data sets, is held securely in coded form at ICES. While data sharing agreements and privacy legislation for the province of Ontario prohibit ICES from making the data set publicly available, access may be granted to those who meet pre-specified criteria for confidential access, available at https://www.ices.on.ca/DAS. Requests to access ICES data may be submitted to ICES Data & Analytic Services at das@ices.on.ca, with information available at https://www.ices.on.ca/DAS/Submitting-your-request. One of the authors (LF) had access to the linked databases and conducted all analyses.