The association between smoking status and hospital length of stay: evidence from a hospital-based cohort.
OBJECTIVE
Smoking is recognized as one of the main preventable causes of mortality and morbidity that imposes a high financial burden on healthcare systems and society. This study aimed to examine the association between smoking status and hospital length of stay (LOS) among patients with lung cancer (LC), chronic obstructive pulmonary disease (COPD) and ischemic heart diseases (IHD) in Iran in 2014.


METHODS
A total of 1271 patients (415 LC patients, 427 COPD patients and 429 IHD patients) were included in the study. Data on age, sex, insurance status and LOS was extracted from the patients' medical records and smoking status was obtained from the patients using telephone survey. The LOS among current smokers, former smokers, and nonsmokers was compared using a zero-truncated poisson regression. Analysis was done using STATA v.12.


RESULTS
The mean LOS for current smokers, former smokers and nonsmokers was 9.4±8.4, 7.3 ±5.3 and 6.02±5.05 days, respectively. The unadjusted and adjusted probabilities of LOS for current smokers and former smokers were 56% and 21% and 48% and 15% higher, respectively, than when compared with the nonsmoker category.


CONCLUSIONS
The study demonstrated longer LOS for the current and former smokers, contributing to the drain on large hospital resources in Iran. The results of the study provide useful information for health-policy makers that contribute to the planning and designing of smoking cessation interventions in this area.
a Research Centre for Environmental Determinants of Health , Kermanshah University of Medical Sciences , Kermanshah , Iran.
Satar
S
Rezaei
b Department of Health Management and Economics, School of Public Health , Tehran University of Medical Sciences , Tehran , Iran.
Ali
A
Akbari Sari
b Department of Health Management and Economics, School of Public Health , Tehran University of Medical Sciences , Tehran , Iran.
Mohammad
M
Arab
c Department of Epidemiology and Biostatistics, School of Public Health and Knowledge Utilization Research Center (KURC) , Tehran University of Medical Sciences (TUMS) , Tehran , Iran.
Reza
R
Majdzadeh
d Savojbolagh Health Center , Alborz University of Medical Sciences , Karaj , Iran.
Faramarz
F
Shaahmadi
e Department of Statistics and Epidemiology, Tabriz Health Services Management Research Center , Tabriz University of Medical Sciences , Tabriz , Iran.
Asghar
A
Mohammadpoorasl
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D019458:Insurance Coverage; D007348:Insurance, Health; D007492:Iran; D007902:Length of Stay / Q000706:statistics & numerical data*; D008175:Lung Neoplasms / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000453:epidemiology*; D029424:Pulmonary Disease, Chronic Obstructive / Q000453:epidemiology*; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking / Q000453:epidemiology*
Iran; Smoking status; hospital length of stay; zero-truncated poisson