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Smoking related discharges, bed days and costs in the acute hospital sector

Smoking related discharges, bed days and costs in the acute hospital sector. Dr Fenton Howell HSE Tobacco Control Framework Implementation Group. Key findings. In 2008 there were 974,054 discharges (35+), using 3.5 million bed days, costing €2.97 billion.

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Smoking related discharges, bed days and costs in the acute hospital sector

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  1. Smoking related discharges, bed days and costs in the acute hospital sector Dr Fenton HowellHSE Tobacco Control Framework Implementation Group

  2. Key findings In 2008 there were 974,054 discharges (35+), using 3.5 million bed days, costing €2.97 billion. Smoking attributable diseases accounted for 36,255 (3.7%) discharges 300,756 (8.7%) bed days € 280 (9.4%) million 95% of the smoking attributable diseases were accounted for by: Cardiovascular and Respiratory Diseases and Cancers.

  3. Introduction Illness and disease associated with smoking give rise to costs for the individual, for society and for the health service. Health service related costs include smoking cessation services, primary care and acute care costs. It is estimated that health care costs related to smoking can involve between 5% and 15% of health care budgets in developed countries Little is known about the true costs to the health sector in Ireland of smoking.

  4. Aims The aim of this study was to quantify the impact of smoking on the acute sector. Number of discharges Bed days used Costs

  5. Methods • Age/gender specific smoking rates for current and ex-smokers: SLAN 07. • International relative risks for 40+ smoking related diseases. • Appropriateness formula calculated. • Apply appropriateness proportions to HIPE data. • HIPE data 2008: discharges, bed days and costs for those age 35+. • HIPE data from Health Research & Information Division, ESRI. • Abstracted using Health Atlas Ireland.

  6. Smoking rates SLAN 2007

  7. Cancers caused by smoking. Internationally used relative risks

  8. Attributable percentages calculated a = [pcur(rcur-1) + pex(rex-1)]*100 / [1+pcur(rcur-1) + pex(rex-1)] • a = attributable percentage for each disease, • pcur = proportion of current smokers, • pex = proportion of ex smokers, • rcur = relative risk of current smokers • rex = relative risk of ex smokers • Analysed using Excel

  9. Cancers caused by smoking: attributable %

  10. CVD caused by smoking: attributable %

  11. Respiratory and other diseases caused by smoking: attributable %

  12. Methods Age/gender specific smoking rates for current and ex-smokers: SLAN 07. International relative risks for 40+ smoking related diseases. Appropriateness formula calculated. Apply appropriateness proportions to HIPE data. HIPE data 2008: discharges, bed days and costs for those age 35+. HIPE data from Health Research & Information Division, ESRI. Abstracted using Health Atlas Ireland.

  13. Cardiovascular Disease

  14. Cancers

  15. Respiratory Disease

  16. Digestive diseases, Cataracts, Hip # and Spontaneous Abortion

  17. Combining males and females

  18. Conclusions Smoking attributable diseases place a significant burden on the acute hospital sector In 2008, smoking attributable diseases account for: 36,255 discharges 300,756 bed days € 280 million Underscores the necessity to invest in cost effective prevention measures which would be a fraction of the above costs. Repeat analysis for subsequent years Need to quantify all healthcare costs associated with smoking

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