Smoke-Free Policies and 30-Day Readmission Rates for Chronic Obstructive Pulmonary Disease
Document Type
Article
Publication Date
11-1-2019
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.
Publication Title
American Journal of Preventive Medicine
Volume
57
Issue
5
First Page
621
Last Page
628
Digital Object Identifier (DOI)
10.1016/j.amepre.2019.06.008
PubMed ID
31564604
ISSN
07493797
E-ISSN
18732607
Citation Information
Stallings-Smith, S., Hamadi, H.Y., Peterson, B.N., Apatu, E.J. I., Spaulding, A.C. (2019). Smoke-Free Policies and 30-Day Readmission Rates for Chronic Obstructive Pulmonary Disease. American Journal of Preventive Medicine, 57(5), 621-628.