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Hospitalization, medical costs increased for smokers with PAD
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Adults with peripheral artery disease who smoke had increased rates of hospitalization and medical costs, according to data published in the Journal of the American College of Cardiology.
“Estimates of tobacco-associated medical care utilization and costs within a PAD population are essential for informing allocation of scarce resources, targeting efforts toward PAD prevention, providing tobacco-cessation best practices, offering focus for future PAD clinical care guidelines and implementing cost-effective treatments,” Sue Duval, PhD, and colleagues from the cardiovascular division, University of Minnesota Medical School, Minneapolis, wrote.
Sue Duval
The researchers conducted a cross-sectional, retrospective study using 2011 claims data from a Minnesota health plan to examine annual total costs, the proportion of members hospitalized and primary discharge diagnoses. The study included two cohorts: patients with PAD who had one or more PAD-related claims (n = 22,203; 9% smokers) and a subgroup of patients with PAD and pharmacy benefits (n = 9,027; 12.8% smokers). Participants were aged at least 40 years and were living in Minnesota.
In 2011, there were 22,220 hospitalizations in the overall PAD cohort and 8,152 in the pharmacy subgroup, according to the results. In the PAD cohort, 49% of smokers were hospitalized vs. 36.4% of nonsmokers (P < .001); in the pharmacy subgroup, 45.1% of smokers were hospitalized vs. 34.6% nonsmokers (P < .001). In both cohorts, smokers were more likely to be hospitalized for peripheral or visceral atherosclerosis (P < .001), acute MI (P < .001) and CHD (P < .05).
Observed smoking-attributable health costs were $18,123 (95% CI, 13,125-23,121) higher for smokers in the overall PAD cohort and $11,795 (95% CI, 6,244-17,346) higher for smokers in the pharmacy subgroup. Additional analysis of facility-based care expenditures in the PAD cohort were $16,233 higher for smokers (P < .001); mean professional care expenditures were $1,502 higher (P < .001) vs. nonsmokers. These results persisted after adjustment.
The researchers also stratified the overall cohort and pharmacy subgroup by whether participants had concurrent CVD. They found that although costs were higher for those with concurrent CVD, the differences between smokers and nonsmokers were only slightly higher in the group with concurrent CVD. Also, men were more likely to incur higher costs than women in adjusted models, and the cost difference between smokers and nonsmokers was more pronounced in men, according to Duval and colleagues.
“This smoking-attributable health and economic burden strongly suggests that tobacco-cessation programs would be especially cost-effective for this population,” Duval and colleagues wrote. – by Trish Shea, MA
Disclosure: Three researchers are employed by Blue Cross Blue Shield of Minnesota. The other researchers report no relevant financial disclosures.
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