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Trends in smoking documentation rates in safety net clinics
Author(s) -
Fortmann Stephen P.,
Bailey Steffani R.,
Brooks Neon B.,
Hitsman Brian,
Rittner Sarah Stuart,
Gillespie Suzanne E.,
Hill Christian Nissen,
Leo Michael C.,
Crawford Phillip M.,
Hu Weiming,
King Dana S.,
O'Cleirigh Conall,
Puro Jon,
Ann McBurnie Mary
Publication year - 2020
Publication title -
health services research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.706
H-Index - 121
eISSN - 1475-6773
pISSN - 0017-9124
DOI - 10.1111/1475-6773.13259
Subject(s) - documentation , medicine , medical record , family medicine , observational study , smoking cessation , incentive , medline , data collection , medical emergency , environmental health , statistics , microeconomics , mathematics , pathology , computer science , political science , law , economics , programming language
Objective To assess the impact of provider incentive policy on smoking status documentation. Data Sources Primary data were extracted from structured electronic medical records (EMRs) from 15 community health centers (CHCs). Study Design This was an observational study of data from 2006 to 2013, assessing changes in documentation of smoking status over time. Data Extraction Methods We extracted structured EMR data for patients age 18 and older with at least one primary care visit. Principal Findings Rates of documented smoking status rose from 30 percent in 2006 to 90 percent in 2013; the largest increase occurred from 2011 to 2012 following policy changes (21.3% [95% CI, 8.2%, 34.4%] from the overall trend). Rates varied by clinic and across patient subgroups. Conclusions Documentation of smoking status improved markedly after introduction of new federal standards. Further improvement in documentation is still needed, especially for males, nonwhite patients, those using opioids, and HIV + patients. More research is needed to study whether changes in documentation lead to improvements in counseling, cessation, and patient outcomes.