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Smokers’ use of acute care hospitals—A prospective study
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by Kathryn Wilkins, Margot Shields and Michelle Rotermann
Abstract
Keywords
Findings
Authors
What is already known on this subject?
What does this study add?
Abstract
Background
Previous Canadian estimates of hospital use by smoking history have been derived by applying disease-specific “smoking-attributable fractions” to administrative data. For this analysis, health survey data were linked to hospitalization data at an individual level, permitting prospective measures of hospital use by smoking status and age.
Data and methods
Data for 28,255 respondents (outside Quebec) to the 2000/2001 Canadian Community Health Survey (CCHS) were linked to the Hospital Person-Oriented Information Database. Days in hospital over four years were quantified for each respondent and examined in relation to smoking status in 2000/2001. Multiple logistic regression was used to examine the association between smoking and hospitalization, while controlling for confounders.
Results
During the four years after their CCHS interview, current daily smokers and former daily smokers who had quit in the past five years averaged more than twice as many days in hospital as did never-daily smokers. Altogether, excess hospital days for current and former smokers aged 45 to 74 numbered 7.1 million over four years, and accounted for 32% of all hospital days used by people in this age group.
Keywords
health surveys, medical record linkage, risk factors
Findings
Hospital care for smoking-related illnesses constitutes an important part of the health care burden. However, because hospital administrative records contain only limited information, quantifying hospital use according to patients’ personal characteristics is challenging. For example, although smoking may have contributed to the illness for which a person is hospitalized, no information on smoking history is captured in the administrative discharge abstract. [Full text]
Authors
Kathryn Wilkins (613-951-1769; kathryn.wilkins@statcan.gc.ca), Margot Shields (613-951-4177; margot.shields@statcan.gc.ca), and Michelle Rotermann (613-951-3166; michelle.rotermann@statcan.gc.ca) are with the Health Analysis Division at Statistics Canada, Ottawa, Ontario K1A 0T6.
What is already known on this subject?
- Smoking causes a variety of diseases and premature death.
- Previous Canadian estimates of smoking-related hospital days—derived from applying disease-specific risk estimates to administrative data—have indicated that smoking accounts for a substantial share of acute care.
What does this study add?
- With population-based survey data linked to hospitalization data, acute care hospital use by smoking status has been prospectively estimated for the cohort of respondents (except those in Quebec) to the 2000/2001 Canadian Community Health Survey.
- Smokers and former smokers had higher odds of hospitalization, even when controling for influences other than smoking.
- Former smokers aged 45 to 64 who had quit for more than five years averaged no more days in hospital than did never-daily smokers.
- Compared with never-daily smokers, excess days used by current daily and former daily smokers aged 45 to 74 amounted to nearly one-third of all acute care hospital days used by the population in this age range.
