Smoking-Attributable Health Care Expenditures for US Adults With Chronic Lower Respiratory Disease.
JAMA Netw Open
; 7(5): e2413869, 2024 May 01.
Article
em En
| MEDLINE
| ID: mdl-38814643
ABSTRACT
Importance Cigarette smoking is a primary risk factor for chronic lower respiratory disease (CLRD) and is associated with worse symptoms among people with CLRD. It is important to evaluate the economic outcomes of smoking in this population. Objective:
To estimate smoking prevalence and cigarette smoking-attributable health care expenditures (SAHEs) for adults with CLRD in the US. Design, Setting, andParticipants:
This cross-sectional study used data from the 2014-2018 and 2020 National Health Interview Surveys (NHIS) and the 2020 Medical Expenditure Panel Survey. The final study population, stratified by age 35 to 64 years and 65 years or older, was extracted from the 2014-2018 NHIS data. The data analysis was performed between February 1 and March 31, 2024. Exposures Cigarette smoking, as classified into 4 categories current smokers, former smokers who quit less than 15 years ago, former smokers who quit 15 or more years ago, and never smokers. Main Outcomes andMeasures:
Smoking-attributable health care expenditures were assessed using a prevalence-based annual cost approach. Econometric models for the association between cigarette smoking and health care utilization were estimated for 4 types of health care services inpatient care, emergency department visits, physician visits, and home health visits.Results:
In the 2014-2018 NHIS study sample of 13â¯017 adults, 7400 (weighted 62.4%) were aged 35 to 64 years, 5617 (weighted 37.6%) were 65 years or older, and 8239 (weighted 61.9%) were female. In 2020, among 11â¯211â¯222 adults aged 35 to 64 with CLRD, 3â¯508â¯504 (31.3%) were current smokers and 3â¯496â¯790 (31.2%) were former smokers. Total SAHEs in 2020 for this age group were $13.6 billion, averaging $2752 per current smoker and $1083 per former smoker. In 2020, 7â¯561â¯909 adults aged 65 years or older had CLRD, with 1â¯451â¯033 (19.2%) being current smokers and 4â¯104â¯904 (54.3%) being former smokers. Total SAHEs in 2020 for the older age group were $5.3 billion, averaging $1704 per current smoker and $682 per former smoker. In sum, SAHEs for adults with CLRD aged 35 years or older amounted to $18.9 billion in 2020. Conclusions and Relevance In this cross-sectional study of adults with CLRD, cigarette smoking was associated with a substantial health care burden. The higher per-person SAHEs for current smokers compared with former smokers suggest potential cost savings of developing targeted smoking cessation interventions for this population.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Gastos em Saúde
Idioma:
En
Ano de publicação:
2024
Tipo de documento:
Article