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Smoking significantly increases annual ED visits

Smoking more than tripled the amount of annual ED visits in a retrospective analysis of Medicaid recipients, according to study results.

Jessica Castner, PhD, RN, assistant professor at the University at Buffalo School of Nursing, and colleagues conducted a retrospective analysis of 2009 Medicaid claims from two Western New York counties consisting of 56,491 individuals aged 18 to 64 years. Castner and colleagues aimed to examine the relationship of behavioral health diagnoses, such as smoking and psychiatric, to determine frequent ED visits.

Jessica Castner

The researchers assigned the selected Medicaid recipients into four categories: healthy (n = 28, 427), at-risk (n = 7,300), chronic conditions (n = 18,795) and system failure (n = 1,969).

The odds of frequent ED visits (more than three per year) for smokers from the healthy category increased more than fourfold (OR = 4.4; 95% CI, 3.9-5), more than doubled in the at-risk (OR = 2.8; 95% CI, 2.3-3.5) and chronic (OR = 2.5; 95% CI, 2.3-2.7) categories and doubled in the system failure group (OR = 2; 95% CI, 1.4-2.8).

Castner and colleagues wrote the results indicate a broken connection between patient needs and services, highlighting the need for health system redesign.

“By stratifying the population by complexity and isolating smoking as a unique substance abuse variable, we provide a richer analytic strategy to guide, prioritize and support ongoing nursing practice intervention,” the researchers wrote. “Greater understanding of the nuanced magnitude and odds ratio within each complexity group highlights the priority need to enhance smoking cessation efforts, substance abuse prevention and treatment … in target complexity-based subpopulations.” – by Ryan McDonald

Disclosure: The researchers report no relevant financial disclosures.