The 130th Annual Meeting of APHA

Abstract #49692

Stephen. J. Jay, MD¹, Elise Papke, MPH¹, and Virgina A. Caine, MD². (1) School of Medicine, Department of Public Health, Indiana University, 1050 Wishard Blvd., RG 4100, Indianapolis, IN 46202, 317-278-0337, sjay@iupui.edu, (2) Marion County Health Department, 3737 North Rural Street, Indianapolis, IN 46205

Hospital medical record documentation of tobacco use status (MRDT) is a valuable tool for linking inpatient and community tobacco prevention and cessation interventions. However, data suggest that MRDT and patient interventions are frequently lacking. As a result, valuable information for planning community health and policy strategies is often lost. As a first step in assessing the inpatient/community linkage in Marion County, we evaluated the adequacy of MRDT. Convenience samples of admissions to inpatient medicine teaching services were identified. Data required for interventions in smokers (U.S. DHHS Clinical Practice Guideline, Treating Tobacco Use and Dependence, 2000), and second-hand smokers (SS), were analyzed: MRDT in 699 patients, (means): social history smoking status, 84%; SS status, 1%; tobacco on problem list, 17%; discharge summary includes: tobacco, 31%; SS, 2%; tobacco on problem list, 16% or SS, 0%; discharge orders: referral to smoking cessation clinic and/or instructions for counseling, 13%. There were minimal changes in these statistics from 1992 to 2001. These data reflect substantial deficiencies in medical record documentation of tobacco status and indicate lost opportunities for tobacco use/prevention interventions. To achieve Healthy People 2010 tobacco goals, an integrated systems approach is needed to ensure that individual patient care and community health outcomes are improved. Effective tobacco prevention/cessation requires the institutionalization of state-of-the-art tobacco control in hospital, ambulatory, and community settings. Through a medicine-public health partnership with Marion County Health Department, recommendations for correcting the identified deficiencies will be incorporated in community tobacco control planning discussions with area hospitals, clinics, and other providers.

Learning Objectives:

At the conclusion of this session, the learner will be able to
• summarize current knowledge about medical record documentation of tobacco use and second-hand smoking,
• identify key systems components in hospital-community tobacco control strategies,
• outline challenges to medicine-public health partnerships in the institutionalization of effective tobacco control across multiple community settings

Keywords: Community Health Planning, Tobacco Control

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.