Dataset Information

The association of smoking status with healthcare utilisation, productivity loss and resulting costs: results from the population-based KORA F4 study.

ABSTRACT:

Background

Smoking is seen as the most important single risk to health today, and is responsible for a high financial burden on healthcare systems and society. This population-based cross-sectional study compares healthcare utilisation, direct medical costs, and costs of productivity losses for different smoking groups: current smokers, former smokers, and never smokers.

Methods

Using a bottom-up approach, data were taken from the German KORA F4 study (2006/2008) on self-reported healthcare utilisation and work absence due to illness for 3,071 adults aged 32-81 years. Unit costs from a societal perspective were applied to utilisation. Utilisation and resulting costs were compared across different smoking groups using generalised linear models to adjust for age, sex, education, alcohol consumption and physical activity.

Results

Average annual total costs per survey participant were estimated as €3,844 [95% confidence interval: 3,447-4,233], and differed considerably between smoking groups with never smokers showing €3,237 [2,802-3,735] and former smokers causing €4,398 [3,796-5,058]. There was a positive effect of current and former smoking on the utilisation of healthcare services and on direct and indirect costs. Total annual costs were more than 20% higher (p<0.05) for current smokers and 35% higher (p<0.01) for former smokers compared with never smokers, which corresponds to annual excess costs of €743 and €1,108 per current and former smoker, respectively.

Conclusions

Results indicate that excess costs for current and former smokers impose a large burden on society, and that previous top-down cost approaches produced lower estimates for the costs of care for smoking-related diseases. Efforts must be focused on prevention of smoking to achieve sustainable containment on behalf of the public interest.

SUBMITTER: Wacker M

PROVIDER: S-EPMC3722023 | biostudies-literature | 2013 Jul

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

The association of smoking status with healthcare utilisation, productivity loss and resulting costs: results from the population-based KORA F4 study.

Wacker Margarethe M Holle Rolf R Heinrich Joachim J Ladwig Karl-Heinz KH Peters Annette A Leidl Reiner R Menn Petra P

BMC health services research 20130717

<h4>Background</h4>Smoking is seen as the most important single risk to health today, and is responsible for a high financial burden on healthcare systems and society. This population-based cross-sectional study compares healthcare utilisation, direct medical costs, and costs of productivity losses for different smoking groups: current smokers, former smokers, and never smokers.<h4>Methods</h4>Using a bottom-up approach, data were taken from the German KORA F4 study (2006/2008) on self-reported ...[more]

PMID: 23866993

Similar Datasets

Project description:OBJECTIVES:To test the effects of body weight maintenance, gain, and loss on health care utilisation in terms of outpatient visits to different kinds of physicians in the general adult population. METHODS:Self-reported utilisation data were collected within two population-based cohorts (baseline surveys: MONICA-S3 1994/95 and KORA-S4 1999/2001; follow-ups: KORA-F3 2004/05 and KORA-F4 2006/08) in the region of Augsburg, Germany, and were pooled for present purposes. N=5,147 adults (complete cases) aged 25 to 64 years at baseline participated. Number of visits to general practitioners (GPs), internists, and other specialists as well as the total number of physician visits at follow-up were compared across 10 groups defined by body mass index (BMI) category maintenance or change. Body weight and height were measured anthropometrically. Hierarchical generalized linear regression analyses with negative binomial distribution adjusted for sex, age, socioeconomic status (SES), survey, and the need factors incident diabetes and first cancer between baseline and follow-up were conducted. RESULTS:In fully adjusted models, compared to the group of participants that maintained normal weight from baseline to follow-up, the following groups had significantly higher GP utilisation rates: weight gain from normal weight (+36%), weight loss from preobesity (+39%), maintained preobesity (+34%), weight gain after preobesity (+43%), maintained moderate obesity (+48%), weight gain from moderate obesity (+107%), weight loss from severe obesity (+114%), and maintained severe obesity (+83%). Regarding internists, those maintaining moderate obesity reported +107% more visits; those with weight gain from moderate obesity reported +91%. The latter group also had +41% more consultations with other physicians. Across all physicians, mean number of visits were estimated at 7.8 per year for maintained normal weight, 9 for maintained preobesity, 11 for maintained moderate obesity, and 12 for maintained severe obesity. Among those with weight loss, the mean number of visits were 8.7, 10.6 and 10.8 for baseline preobesity, moderate obesity, and severe obesity, respectively. Finally, those with weight gain from normal weight and preobesity reported 9.4 and 9.3 visits, respectively, and those with baseline moderate and follow-up severe obesity reported 13.1 visits (the most overall). Women reported higher GP and other physician utilisation. While all utilisation rates increased with age, GP utilisation was lower in middle to high SES groups. CONCLUSION:Compared to maintained normal weight over a 7- to 10-year period, maintained overweight, weight gain and weight loss are associated with higher outpatient physician utilisation in adults, especially after baseline obesity. These effects only partly became insignificant after inclusion of incident diabetes or first cancer into the model. Future research should further elucidate the associations between weight development and health care utilisation by BMI status and the mechanisms underlying these associations.

Project description:BackgroundThe Affordable Care Act mandates that new insurance plans cover smoking-cessation therapy without cost-sharing. Previous cost difference estimates, which show a spike around the time of cessation, suggest premiums might rise as a result of covering these services.PurposeThe goal of the study was to test (1) whether individuals in an RCT of pharmacotherapy and counseling for smoking cessation differed in their healthcare costs around the cessation period, and (2) whether the healthcare costs of those in the trial who successfully quit were different from a matched sample of smokers in the community.MethodsGeneralized linear regression models were used to analyze healthcare cost data on individuals enrolled in a comparative effectiveness trial of cessation therapies between October 2005 and May 2007 (1346 total participants; 1338 with requisite data for further analysis). Cost differences for the period preceding and subsequent to the cessation attempt were assessed by trial participants' 12-month sustained quit status. Healthcare cost differences between sustained quitters and a sample of community-dwelling smokers, matched to these quitters on the basis of health services use around the time trial participant enrolled and by demographics, were also examined. Data were analyzed in 2011.ResultsAll three groups had a spike in cost associated with the index clinic visit. Regression results revealed little difference in healthcare costs by quit status for trial participants until the sixth quarter post-quit. By that quarter, continuous sustained quitters cost $541 (p<0.001) less than continuing smokers. Continuous sustained quitters cost less than their matched community- dwelling smokers in almost every quarter observed. The cost difference ranged from $270 (p=0.01) during the quarter of quit, to $490 (p<0.01) in the 6th quarter after quitting.ConclusionsThe inclusion of smoking-cessation therapy does not appear to raise short-term healthcare costs. By the sixth quarter post-quit, sustained quitters were less costly than trial participants who continued smoking.

Project description:ObjectiveTemporomandibular joint disorder (TMD) requires long-term management and can be a financial burden for patients. Here, we investigated the treatment received by people diagnosed with TMD and its relevant costs.DesignA descriptive, cross-sectional study.Setting and participantsWe performed secondary data analysis of health insurance claims data provided by the Health Insurance Assessment and Review (HIRA) of the Republic of Korea. We reviewed the records of 10 041 patients who were diagnosed with TMD and who utilised outpatient healthcare service at least once between January and December 2017.Primary and secondary outcome measuresData on use of medical services, hospitalisations, sociodemographic factors, treatment and medication were retrieved and analysed. Cost was defined as the cost of care incurred by a health insurance beneficiary at a care facility.ResultsWe reported the characteristics as medians, frequencies and percentages and found that most TMD patients were outpatients, women (58.9%) and in their 20s (46.4%). For visit type, 85.9% of all patients had an outpatient dental medical visit, with most visiting dental clinics and dental hospitals. Western medicine (WM; 9.8%) was prescribed more often, followed by Korean medicine (KM; 8.2%). The median expense per patient was highest among those in their 20s (58.00, 23.90, 53.40, 65.90 US$ for overall, WM, dental medicine (DM) and KM, respectively). Consultation fees accounted for the greatest percentage (42.8%) of DM and WM care expenses, while injection/non-surgical intervention fees accounted for the greatest percentage of KM care expenses. The most commonly used treatments for TMD were temporomandibular joint stimulation therapy (51.1%) and acupuncture (19.9%), considered as the most basic care for TMD. Psychosomatic agents (86.4%) were the most commonly used medications in outpatients.ConclusionsWhile people with TMD most commonly received temporomandibular stimulation therapy, the costs and duration of treatment varied significantly for these patients.

Dataset Information

The association of smoking status with healthcare utilisation, productivity loss and resulting costs: results from the population-based KORA F4 study.

Background

Methods

Results

Conclusions

Publications

The association of smoking status with healthcare utilisation, productivity loss and resulting costs: results from the population-based KORA F4 study.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets