Smoke-Free Policies and 30-Day Readmission Rates for Chronic Obstructive Pulmonary Disease.
Am J Prev Med
; 57(5): 621-628, 2019 11.
Article
em En
| MEDLINE
| ID: mdl-31564604
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.
Texto completo:
1
Coleções:
01-internacional
Temas:
Geral
Base de dados:
MEDLINE
Assunto principal:
Readmissão do Paciente
/
Centers for Medicare and Medicaid Services, U.S.
/
Doença Pulmonar Obstrutiva Crônica
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Política Antifumo
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Implementação de Plano de Saúde
Tipo de estudo:
Evaluation_studies
/
Prognostic_studies
/
Risk_factors_studies
/
Sysrev_observational_studies
Limite:
Aged
/
Female
/
Humans
/
Male
País/Região como assunto:
America do norte
Idioma:
En
Revista:
Am J Prev Med
Assunto da revista:
SAUDE PUBLICA
Ano de publicação:
2019
Tipo de documento:
Article