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ABSTRACT: Objectives
To assess the medical expenditures of American adults by their smoking status-Current, Former or Never smokers. We update these expenditures through 2015 controlling for personal characteristics and medical history and assess the impact of years-since-quitting and decade of life.Setting and participants
Weighted sample of American adults, 2011-2015. The linked National Health Interview Survey (NHIS) and Medical Expenditure Panel Survey (MEPS) are annual weighted representations of approximately 250?million adults. Sampling of NHIS is multistage with data collected throughout the year.Primary outcome measures
Using data from NHIS and MEPS, we collected demographic data, self-reported medical history and current smoking status. Smoking status was designated as Never, Current and Former, along with years-since-quitting. Total medical expenditures were collected from MEPS for 2011-2015. We used Manning's two-part model to estimate average expenditures per individual and marginal costs for individuals at all levels of smoking status.Results
American adults averaged US$4830 in average medical expenditures. Never smokers (US$4360, 95%?CI 4154.3 to 4566.3), had lower expenditures than Current (US$5244, 95%?CI 4707.9 to 5580.3) and Former (US$5590, 95%?CI 5267.4 to 5913.5) smokers. CI for Current and Former smokers overlapped. Results were similarly significant when controlling for disease history. Years-since-quitting did not affect expenditures. In each decade of adult life, Former smokers had the highest annual medical expenditures, followed by Current and then Never smokers.Conclusions
We updated annual medical expenditures during the Affordable Care Act era by smoking status using the current best practice model. While we identify Former smokers as having higher medical expenditures than Current smokers, we do not examine how care-seeking behaviour varies between levels of each risk factor.
SUBMITTER: Swedler DI
PROVIDER: S-EPMC6661572 | biostudies-literature | 2019 Jul
REPOSITORIES: biostudies-literature
Swedler David I DI Miller Ted R TR Ali Bina B Waeher Geetha G Bernstein Steven L SL
BMJ open 20190716 7
<h4>Objectives</h4>To assess the medical expenditures of American adults by their smoking status-Current, Former or Never smokers. We update these expenditures through 2015 controlling for personal characteristics and medical history and assess the impact of years-since-quitting and decade of life.<h4>Setting and participants</h4>Weighted sample of American adults, 2011-2015. The linked National Health Interview Survey (NHIS) and Medical Expenditure Panel Survey (MEPS) are annual weighted repres ...[more]