Alkhoury Dana, Atchison Jared, Trujillo Antonio J, Oslin Kimberly, Frey Katherine P, O'Toole Robert V, Castillo Renan C, O'Hara Nathan N
Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Department of Orthopaedics, University of Maryland School of Medicine, 110 South Paca St., Suite 300, Baltimore, MD, USA.
Health Econ Rev. 2021 Apr 26;11(1):15. doi: 10.1186/s13561-021-00313-3.
Smoking increases the risk of complications and related costs after an orthopaedic fracture. Research in other populations suggests that a one-time payment may incentivize smoking cessation. However, little is known on fracture patients' willingness to accept financial incentives to stop smoking; and the level of incentive required to motivate smoking cessation in this population. This study aimed to estimate the financial threshold required to motivate fracture patients to stop smoking after injury.
This cross-sectional study utilized a discrete choice experiment (DCE) to elicit patient preferences towards financial incentives and reduced complications associated with smoking cessation. We presented participants with 12 hypothetical options with several attributes with varying levels. The respondents' data was used to determine the utility of each attribute level and the relative importance associated with each attribute.
Of the 130 enrolled patients, 79% reported an interest in quitting smoking. We estimated the financial incentive to be of greater relative importance (ri) (45%) than any of the included clinical benefits of smoking cessations (deep infection (ri: 24%), bone healing complications (ri: 19%), and superficial infections (ri: 12%)). A one-time payment of $800 provided the greatest utility to the respondents (0.64, 95% CI: 0.36 to 0.93), surpassing the utility associated with a single $1000 financial incentive (0.36, 95% CI: 0.18 to 0.55).
Financial incentives may be an effective tool to promote smoking cessation in the orthopaedic trauma population. The findings of this study define optimal payment thresholds for smoking cessation programs.
吸烟会增加骨科骨折后出现并发症的风险及相关费用。对其他人群的研究表明，一次性付款可能会激励戒烟。然而，对于骨折患者接受经济激励以戒烟的意愿以及促使该人群戒烟所需的激励水平，我们知之甚少。本研究旨在估计促使骨折患者受伤后戒烟所需的经济阈值。
这项横断面研究采用离散选择实验（DCE）来了解患者对经济激励以及与戒烟相关的并发症减少的偏好。我们向参与者展示了12个具有不同属性水平的假设选项。受访者的数据用于确定每个属性水平的效用以及与每个属性相关的相对重要性。
在130名登记患者中，79%表示有戒烟意愿。我们估计经济激励的相对重要性（ri）（45%）高于戒烟所带来的任何一项临床益处（深部感染（ri：24%）、骨愈合并发症（ri：19%）和浅表感染（ri：12%））。一次性支付800美元给受访者带来的效用最大（0.64，95%置信区间：0.36至0.93），超过了单次1000美元经济激励带来的效用（0.36，95%置信区间：0.18至0.55）。
经济激励可能是促进骨科创伤人群戒烟的有效工具。本研究结果确定了戒烟项目的最佳支付阈值。
