260193 Association between Emergency Department utilization by Kentucky Medicaid patients and smoke-free ordinances

Tuesday, October 30, 2012

Amie Goodin, MPP , Martin School of Public Policy and Administration, University of Kentucky, Lexington, KY
Amanda Fallin, PhD, RN , Center for Tobacco Policy Research and Education, University of California San Francisco, San Francisco, CA
Jeffery Talbert, PhD , Institute for Pharmaceutical Outcomes and Policy, University of Kentucky, Lexington, KY
Several Kentucky communities have passed smoke-free ordinances since 2000. The purpose of this study is to determine if the rate of Emergency Department (ED) visits for smoking-related respiratory and cardiovascular health events changed after the passage of a community smoke-free ordinance in children and adults enrolled in Medicaid. Using Medicaid claims data, rates of ED visits within counties from before and after the passage of a smoke-free ordinance were calculated from patients that had a primary or secondary diagnosis of asthma, bronchitis, emphysema, MI, or stroke. The study design is a retrospective analysis, where treatment counties are defined as a county that has passed an ordinance and control counties are defined as a county that has not passed an ordinance. A regression model was used to analyze the data and control for the strength of the policy, demographic factors, differences in region, and the time periods between the passages of ordinances. It was found that counties with strong ordinances had lower ED rates for adults with asthma than counties with no ordinances or weak ordinances (p=0.010) and counties with strong (p<0.001) and weak (p=0.001) ordinances had lower ED rates for MI. The results of this study demonstrate some of the health effects of smoke-free ordinances on Kentucky Medicaid beneficiaries, which is a vulnerable population that faces health disparities. The implementation of smoke-free ordinances has been controversial in many Kentucky communities and the findings from this interdisciplinary project could have implications for future policy changes.

Learning Areas:
Public health or related public policy

Learning Objectives:
This study evaluates the differences in ED utilization rates for certain respiratory and cardiovascular events in counties that have and have not passed smoke-free ordinances.

Keywords: Medicaid, Tobacco Policy

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a doctoral student whose studies focus on problems of health policy.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.