Patients who smoke present physicians and hospitals with a whole range of costly issues.
Would a smoking cessation program, which itself is also expensive, save money in the long run?
A team of New York University researchers looked at that specific issue and published the results of their study, “Cost-Effectiveness of Preoperative Smoking Cessation Interventions in Total Joint Arthroplasty,” in the February 2019 edition of The Journal of Arthroplasty.
Joseph Bosco, M.D., professor in the department of Orthopaedic Surgery at NYU Langone Orthopedics, co-author on the study and vice chair for clinical affairs at the Department of Orthopaedic Medicine, explained the rationale and objective of this research to OTW, “Peri-operative smoking cessation programs are high value interventions that improve lives and are cost effective. NYU Langone Orthopedics began participating in Medicare total joint bundles in 2013.”
“We quickly realized that smoking was a modifiable risk factor that needed to be addressed in order to provide the best care possible for our patients. Thus, we developed a peri-operative smoking cessation program for our joint replacement patients.”
“In our model, the average 90-day cost was $32 less for patients enrolled in a mandatory smoking cessation intervention ($23,457) compared with patients who were not ($23,489). In sensitivity analyses, the smoking cessation intervention was cost-saving vs no intervention when the short-term cost of PJI [periprosthetic joint infection] was greater than $95,410, the rate of PJI was reduced by at least 25% for former vs current smokers, the cost of the intervention was less than $219, or the success rate of the intervention was greater than 56%.”
Co-author James Slover, M.D., is associate professor of Orthopedic Surgery, NYU Langone Health. He told OTW, “The most important result of this study is that the cost of smoking cessation programs is more than made up for by the improved outcomes they lead to. All patients who smoke and who are scheduled for an elective joint replacement should be enrolled in a smoking cessation program.”
“Furthermore, in a health care environment where all cost must be scrutinized for the outcomes they produce, smoking cessation programs are highly cost effective.”
“Our fellow surgeons need to understand that peri-operative smoking cessation programs are essential for providing the highest value care and best outcomes in those patients who smoke and who are scheduled for elective joint replacement.”
