Health Care Expenditures Attributable to Smoking in Military Veterans
Health Care Expenditures Attributable to Smoking in Military Veterans
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DOI：
10.1093/ntr/ntu187
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发表时间：
2015-05-01
影响因子：
4.7
通讯作者：
Max, Wendy
中科院分区：
文献类型：
--
作者：
Barnett, Paul G.;Hamlett-Berry, Kim;Max, Wendy
简介：据估计，吸烟对健康的影响占美国医疗保健支出的 6%-8%。我们估算了退伍军人健康管理局 (VHA) 因吸烟引起的医疗保健费用。方法：VHA 调查和管理数据提供了退伍军人登记人数、当前和以前的吸烟率，以及按年龄、性别和地区定义的 4 种护理类型的费用。成本和吸烟状况无法在参与者层面联系起来，因此我们使用了在可以建立联系的美国居民样本中估计的吸烟归因分数。结果：2010 年，参加 VHA 的 770 万退伍军人收到了 402 亿美元的 VHA 提供的医疗服务。我们估计，VHA 成本中有 27 亿美元可归因于吸烟对健康的影响。这占 353 亿美元用于可确定吸烟归因分数的护理类型的 7.6%。因吸烟引起的住院费用比例 (11.4%) 高于因吸烟引起的门诊费用比例 (5.3%)。当前吸烟者的成本（17 亿美元）比以前吸烟者的成本（9.83 亿美元）更多。结论：吸烟导致的 VHA 成本比例与其他医疗保健系统的成本相似。退伍军人中的吸烟率正在缓慢下降，但在患有精神疾病和药物滥用疾病的退伍军人以及年轻和女性退伍军人中，吸烟率仍然很高。 VHA 已采取了许多戒烟计划，这些计划有可能降低未来吸烟造成的成本。
Introduction: The health effects of cigarette smoking have been estimated to account for between 6%-8% of U.S. health care expenditures. We estimated Veterans Health Administration (VHA) health care costs attributable to cigarette smoking.Methods: VHA survey and administrative data provided the number of Veteran enrollees, current and former smoking prevalence, and the cost of 4 types of care for groups defined by age, gender, and region. Cost and smoking status could not be linked at the enrollee level, so we used smoking attributable fractions estimated in sample of U.S. residents where the linkage could be made.Results: The 7.7 million Veterans enrolled in VHA received $40.2 billion in VHA provided health services in 2010. We estimated that $2.7 billion in VHA costs were attributable to the health effects of smoking. This was 7.6% of the $35.3 billion spent on the types of care for which smoking-attributable fractions could be determined. The fraction of inpatient costs that was attributable to smoking (11.4%) was greater than the fraction of ambulatory care cost attributable to smoking (5.3%). More cost was attributable to current smokers ($1.7 billion) than to former smokers ($ 983 million).Conclusions: The fraction of VHA costs attributable to smoking is similar to that of other health care systems. Smoking among Veterans is slowly decreasing, but prevalence remains high in Veterans with psychiatric and substance use disorders, and in younger and female Veterans. VHA has adopted a number of smoking cessation programs that have the potential for reducing future smoking-attributable costs.