Key Finding and Impact
Automated, opt-out inpatient tobacco cessation services delivered by interactive voice response decreases readmissions and healthcare charges.
Tobacco use and its related morbidity and mortality are burdens to the U.S. health system.
Tobacco use in the United States continues to be a significant healthcare concern. In addition to causing approximately 480,000 deaths annually and resulting in nearly $300 billion in healthcare spending each year, tobacco use is also a known risk factor for hospital admissions and readmissions. The benefits of in-hospital smoking cessation programs have been documented; however, these programs can be expensive to implement. Dr. Kathleen Cartmell and her research team at the Medical University of South Carolina (MUSC) wanted to examine the cost-effectiveness of these programs and their impact on hospital readmission rates.
Using technology to follow up with in-hospital tobacco treatment services.
- Dr. Kathleen Cartmell
Implemented in 2014 to meet Joint Commission tobacco treatment standards, MUSC’s automated opt-out Tobacco Dependence Treatment Service (TDTS) interfaced with the hospital’s admission and discharge records to identify tobacco users and refer these patients to in-hospital tobacco cessation services. Using Interactive Voice Response (IVR), patients received automated followup phone calls to assess tobacco use and provide referrals to community tobacco cessation services at 3, 14, 30, 90, and 180 days after hospital discharge.
Smoking cessation using IVR can reduce readmission rates and lower healthcare charges.
Dr. Cartmell examined differences in readmission rates and healthcare costs between TDTS users and those who did not receive the service. Those using the TDTS service were 23 percent less likely to be readmitted to the hospital 30 days after discharge. Their healthcare charges were also, on average, $7,299 lower than smokers who did not receive TDTS. These findings suggest that an automated, opt-out inpatient TDTS service could decrease readmissions and healthcare costs for patients, increase efficiency in patient care for the hospital, and decrease claims for insurers. Dr. Cartmell wants to see additional studies to validate the findings, whose results may encourage healthcare systems to invest in TDTS programs.