Trends in tobacco use and tobacco cessation counselling codes among Medicare beneficiaries, 2001–2014

Abstract

Background Analysis of Medicare data is often used to determine epidemiology, healthcare utilization and effectiveness of disease treatments. We were interested in whether Medicare data could be used to estimate prevalence of tobacco use. Currently, data regarding tobacco use is derived from Behavioral Risk Factor Surveillance System (BRFSS) survey data. We compare administrative claims data for tobacco diagnosis among Medicare beneficiaries to survey (BRFSS) estimates of tobacco use from 2001 to 2014. Methods Retrospective cross-sectional study comparing tobacco diagnoses using International Classification of Disease, Ninth Revision (ICD-9) codes for tobacco use in Medicare data to BRFSS data from 2001 to 2014 in adults age ≥ 65 years. Beneficiary data included age, gender, race, socioeconomic status, and comorbidities. Tobacco cessation counselling was also examined using Healthcare Common Procedure Coding System codes. Results The prevalence of Medicare enrollees aged ≥65 years who had a diagnosis of current tobacco use increased from 2.01% in 2001 to 4.8% in 2014, while the estimates of current tobacco use from BRFSS decreased somewhat (10.03% in 2001 vs. 8.77% in 2014). However, current tobacco use based on Medicare data remained well below the estimates from BRFSS. Use of tobacco cessation counselling increased over the study period with largest increases after 2010. Conclusions The use of tobacco-related diagnosis codes increased from 2001 to 2014 in Medicare but still substantially underestimated the prevalence of tobacco use compared to BRFSS data.

Characteristics and Factors Associated With Mortality in Patients With Coronavirus Disease 2019 and Pneumothorax

“…Third, caution should be exercised while evaluating the potential effects of smoking status, which is found to be highly specific but less than 10% sensitivity, which has not changed over time with the use of administrative datasets. 26,27 Fourth, it is possible that undiagnosed pneumothorax cases and deaths attributed to these occurred, which might have led to the underreporting of the true rate of occurrence and attributable mortality. Further, we could neither stratify patients by the severity of respiratory parameters, such as oxygenation or lung mechanics, nor determine whether the best practices that may affect outcome, such as lung-protective ventilation strategies, were adhered to; however, prior reports examining this across the United States have shown adherence to these best practices.…”

Tabagismo em idosos

“…Como veremos na categoria a seguir, a idade é importante preditor para a cessação tabágica e busca pela melhora na qualidade de vida, o que enaltece a necessidade de mais produções científicas acerca do assunto para melhor compreensão e abordagem. (16,20,41,43,44). Como já supracitado, este vínculo com o profissional prescritor acarreta um compromisso a ser honrado pelo paciente tabagista, mais uma vez herança do zelo e apreço pela disposição profissional e de uma terapia prescritiva individualizada (20,44).…”

Participation in a Medicare advanced primary care model and the delivery of high‐value services

“…Despite their high value and CMS's efforts to encourage their delivery, the use of these services is suboptimal 7,13–16 . In addition, studies have shown lower use among Medicare beneficiaries who are of non‐White race, male, lower income, less educated, and enrolled in Medicaid 16–21 . Obstacles to using AWVs include Medicare's complex and sometimes confusing billing requirements.…”

“…For ACP, challenges include relatively low payment rates and unclear billing requirements 7 . Obstacles to using other preventative services include limits on beneficiary–provider encounter time, which often focuses on the diseases that triggered the visit, rather than discussing risk factors such as tobacco use or depression 18,19,23,24 …”

“…7,[13][14][15][16] In addition, studies have shown lower use among Medicare beneficiaries who are of non-White race, male, lower income, less educated, and enrolled in Medicaid. [16][17][18][19][20][21] Obstacles to using AWVs include Medicare's complex and sometimes confusing billing requirements. This may especially deter providers caring for underserved or rural populations from delivering these services since they may have greater workload or difficulty filling clinical positions to help provide AWVs.…”