2023-09-28 14:46:10 +00:00
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abstract: 'Background: Insurance coverage of tobacco cessation medications
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increases their use and reduces smoking prevalence in a population.
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However, uncertainty about the impact of this coverage on health care
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utilization and costs is a barrier to the broader adoption of this
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policy, especially by publicly funded state Medicaid insurance programs.
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Whether a publicly funded tobacco cessation benefit leads to decreased
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medical claims for tobacco-related diseases has not been studied. We
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examined the experience of Massachusetts, whose Medicaid program adopted
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comprehensive coverage of tobacco cessation medications in July 2006.
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Over 75,000 Medicaid subscribers used the benefit in the first 2.5
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years. On the basis of earlier secondary survey work, it was estimated
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that smoking prevalence declined among subscribers by 10\% during this
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period.
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Methods and Findings: Using claims data, we compared the probability of
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hospitalization prior to use of the tobacco cessation pharmacotherapy
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benefit with the probability of hospitalization after benefit use among
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Massachusetts Medicaid beneficiaries, adjusting for demographics,
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comorbidities, seasonality, influenza cases, and the implementation of
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the statewide smoke-free air law using generalized estimating equations.
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Statistically significant annualized declines of 46\% (95\% confidence
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interval 2\%-70\%) and 49\% (95\% confidence interval 6\%-72\%) were
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observed in hospital admissions for acute myocardial infarction and
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other acute coronary heart disease diagnoses, respectively. There were
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no significant decreases in hospitalizations rates for respiratory
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diagnoses or seven other diagnostic groups evaluated.
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Conclusions: Among Massachusetts Medicaid subscribers, use of a
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comprehensive tobacco cessation pharmacotherapy benefit was associated
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with a significant decrease in claims for hospitalizations for acute
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myocardial infarction and acute coronary heart disease, but no
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significant change in hospital claims for other diagnoses. For
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low-income smokers, removing the barriers to the use of smoking
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cessation pharmacotherapy has the potential to decrease short-term
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utilization of hospital services.'
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affiliation: 'Land, T (Corresponding Author), Massachusetts Tobacco Cessat \& Prevent
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Program, Boston, MA USA.
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Land, Thomas; Paskowsky, Mark; Warner, Donna; Kwass, Jo-Ann; Keithly, Lois, Massachusetts
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Tobacco Cessat \& Prevent Program, Boston, MA USA.
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Rigotti, Nancy A.; Levy, Douglas E., Massachusetts Gen Hosp, Dept Med, Tobacco Res
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\& Treatment Ctr, Div Gen Med, Boston, MA 02114 USA.
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Rigotti, Nancy A.; Levy, Douglas E., Harvard Univ, Sch Med, Boston, MA USA.
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Rigotti, Nancy A.; Levy, Douglas E., Massachusetts Gen Hosp, Mongan Inst Hlth Policy,
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Boston, MA 02114 USA.
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Wetherell, LeAnn, Off Medicaid Commonwealth Massachusetts, Boston, MA USA.'
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article-number: e1000375
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author: Land, Thomas and Rigotti, Nancy A. and Levy, Douglas E. and Paskowsky, Mark
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and Warner, Donna and Kwass, Jo-Ann and Wetherell, LeAnn and Keithly, Lois
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author-email: Thomas.Land@state.ma.us
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author_list:
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- family: Land
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given: Thomas
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- family: Rigotti
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given: Nancy A.
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- family: Levy
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given: Douglas E.
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- family: Paskowsky
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given: Mark
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- family: Warner
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given: Donna
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- family: Kwass
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given: Jo-Ann
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- family: Wetherell
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given: LeAnn
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- family: Keithly
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given: Lois
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da: '2023-09-28'
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doi: 10.1371/journal.pmed.1000375
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files: []
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issn: 1549-1277
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journal: PLOS MEDICINE
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keywords-plus: 'ACUTE MYOCARDIAL-INFARCTION; CORONARY-HEART-DISEASE; SMOKING-CESSATION;
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UNITED-STATES; QUITTING SMOKING; HEALTH; RISK; MORTALITY; EXPOSURE;
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CHARGES'
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language: English
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month: DEC
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number: '12'
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number-of-cited-references: '25'
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orcid-numbers: Levy, Douglas/0000-0001-9446-7899
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papis_id: edd46f9594462421edaa5910efff944a
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ref: Land2010longitudinalstudy
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researcherid-numbers: Levy, Douglas/W-1516-2019
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times-cited: '37'
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title: A Longitudinal Study of Medicaid Coverage for Tobacco Dependence Treatments
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in Massachusetts and Associated Decreases in Hospitalizations for Cardiovascular
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Disease
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2023-10-01 08:15:07 +00:00
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type: article
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2023-09-28 14:46:10 +00:00
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unique-id: WOS:000285499600002
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usage-count-last-180-days: '0'
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usage-count-since-2013: '7'
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volume: '7'
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web-of-science-categories: Medicine, General \& Internal
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year: '2010'
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