Smokers Pay Higher Hospital Costs For Surgery
May 30, 2012

Smokers Pay Higher Hospital Costs For Surgery

Connie K. Ho for

Smokers beware. Smoking is known to be harmful to your health, but it can be detrimental to your pocketbook as well. A study published in the June 2012 issue Journal of the American College of Surgeons reports that surgical patients who smoke tend to have higher hospital costs for elective general surgery than nonsmokers. The project showed that a significant amount of the health care costs was due to postoperative respiratory complications.

According to the study, around 30 percent of patients who undergo elective general surgery procedures are smokers. In a prepared statement, Dr. Aparna S. Kamath, lead study author and clinical assistant professor of internal medicine at the University of Iowa Hospitals and Clinics, explained how there was little information that compared the surgical costs of smokers to nonsmokers. Kamath and her colleagues looked at the data of 14,853 patients who had participated in a general surgery operation in 123 Veteran Affairs Medical Centers over one year.

The patients, who were mostly white males, were placed into three different groups. Overall, 34 percent were current smokers who had smoked within the year before their operation, 39 percent were former smokers who had a history of smoking but had not smoked in the year before the operation, and 27 percent had never smoked before.

Researchers looked at hospital costs in terms of the operation, the readmission within 30 days of discharge, and the time spent in the hospital during the hospital stay. The researchers controlled factors like age and urgency of health procedure as well as health conditions such as chronic obstructive pulmonary disease, coronary artery disease, diabetes, and hypertension. The project´s findings showed that current smokers had to pay four percent more for inpatient costs than nonsmokers. It equaled almost $900 more for each smoking patient that underwent a surgery. Researchers also found that patients who had more complex procedures paid six percent more if they were smokers versus nonsmokers. Furthermore, according to Kamath, the added expense for smokers was based off postoperative respiratory complications and not length of hospital stay.

"It wasn't a surprise, but it's important to actually prove this expectation," noted Kamath in a statement.

Kamath believes that the results of the project show the need for pre-operative behavioral interventions to help smokers quit the habit.

"This research just strengthens our belief that we should encourage patients to quit smoking before their operations because of respiratory complications, in order to improve their surgical outcomes. In addition, it provides health care stakeholders and decision makers with data to make a business case for preoperative smoking cessation interventions," commented Kamath.

In terms of behavioral interventions, even short spurts of smoking cessation can be beneficial.

“Although our research did not directly address this issue, evidence suggests that quitting smoking before an operation, even as little as four to six weeks prior to the procedure, improves postoperative outcomes and decreases complications in patients," said Kamath in the statement. "I think it's important to use the time before a surgical procedure as a teachable moment."