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International Journal of Public Health
Published in: International Journal of Public Health 6/2013

01-12-2013 | Original Article

Disparities in health care utilization by smoking status in Canada

Authors: Sunday Azagba, Mesbah Fathy Sharaf, Christina Xiao Liu

Published in: International Journal of Public Health | Issue 6/2013

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Abstract

Objectives

To examine the association between smoking status and the utilization of health care services in Canada.

Methods

The study uses data from the 2007 Canadian Community Health Survey, which contains information on the number of visits to general practitioner (GP), specialists (SP) and the number of nights spent in a hospital. The finite mixture estimation method is used in order to account for heterogeneity among smokers.

Results

Multivariate regression results indicate differential effects of smoking on health care utilization for at least two different groups of health care users: low and high users. In particular, we find that among the low-use group, smokers use less GP and SP services than never smokers. However, for the low-use and high-use groups, smokers have more hospitalizations than never smokers. The incidence of hospitalization is higher for the low-use group after controlling for need, socio-demographic characteristics and province fixed effects. Former smokers who recently quit use more health care services.

Conclusions

Tobacco consumption elevates the use of health care services, especially among the high-use group.
Appendix
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Literature
Al-Windi A, Dag E, Kurt S (2002) The influence of perceived wellbeing and reported symptoms on health care utilization: a population-based study. J Clin Epidemiol 55:60–66CrossRefPubMed
Bago d’Uva T (2006) Latent class models for utilization of health care. Health Econ 15:329–343CrossRef
Baliunas D, Patra J, Rehm J, Popova S, Taylor B (2007) Smoking-attributable morbidity: acute care hospital diagnoses and days of treatment in Canada 2002. BMC Public Health 7:247CrossRefPubMedCentralPubMed
Baumeister RF, Vohs KD, Tice DM (2007) The strength model of self-control. Curr Dir Psychol Sci 16:351–355CrossRef
Cameron AC, Trivedi PK (1998) Regression analysis of count data. Econometric society monograph, No. 30. Cambridge University Press, Cambridge UKCrossRef
Centers for Disease Control and Prevention (2008) Smoking-attributable mortality, years of potential life lost, and productivity losses-United States, 2000–2004. Morb Mortal Wkly Rep 57:1226–1228
Chern JY, Wan TT, Begun JW (2002) A structural equation modeling approach to examining the predictive power of determinants of individuals’ health expenditures. J Med Syst 26:323–336CrossRefPubMed
Collishaw NE, Myers G (1984) Dollar estimates of the consequences of tobacco use in Canada, 1979. Can J Public Health 75:192–199PubMed
Deb P, Trivedi PK (1997) Demand for medical care by the elderly: a finite mixture approach. J Appl Econom 12:313–336CrossRef
Deb P, Trivedi PK (2002) The structure of demand for health care: latent class versus two-part models. J Health Econ 21:601–625CrossRefPubMed
Fishman PA, Khan ZM, Thompson EE, Curry SJ (2003) Health care costs among smokers, former smokers, and never smokers in an HMO. Health Serv Res 38:733–749CrossRefPubMedCentralPubMed
Fishman PA, Thompson EE, Merikle E, Curry SJ (2006) Changes in health care costs before and after smoking cessation. Nicotine Tob Res 8:393–401CrossRefPubMed
Gerdtham UG, Trivedi PK (2001) Equity in Swedish health care reconsidered: new results based on the finite mixture model. Health Econ 10:565–572CrossRefPubMed
Gruber J, Koszegi B (2004) Tax incidence when individuals are time-inconsistent: the case of cigarette excise taxes. J Public Econ 88:1959–1987CrossRef
Haapanen-Niemi N, Miilunpalo S, Vuori I, Pasanen M, Oja P (1999) The impact of smoking, alcohol consumption, and physical activity on use of hospital services. Am J Public Health 89:691–698CrossRefPubMedCentralPubMed
Harrison GW, Feehan JP, Edwards AC, Segovia J (2003) Cigarette smoking and the cost of hospital and physician care. Can Public Policy 29:1–19CrossRef
Heckman J, Singer B (1984) A method for minimizing the impact of distributional assumptions in econometric models for duration data. Econometrica 52:271–320CrossRef
Hvidtfeldt UA, Rasmussen S, Gronbaek M, Becker U, Tolstrup JS (2010) Influence of smoking and alcohol consumption on admissions and duration of hospitalization. Eur J Public Health 20(4):376–382CrossRefPubMed
Jones AM (2000) Health econometrics. Handbook of health economics, vol Vol. 1. Elsevier, North Holland, pp 265–344
Kahende JW, Adhikari B, Maurice E, Rock V, Malarcher A (2009) Disparities in health care utilization by smoking status—NHANES 1999–2004. Int J Environ Res Public Health 6:1095–1106CrossRefPubMedCentralPubMed
Kaiserman MJ (1997) The cost of smoking in Canada, 1991. Chronic Dis Can 18:13–19PubMed
Lourenço ÓD, Ferreira PL (2005) Utilization of public health centres in Portugal: effect of time costs and other determinants. Finite mixture models applied to truncated samples. Health Econ 14:939–953CrossRefPubMed
Martinson BC, Crain AL, Pronk NP, O’Connor PJ, Maciosek MV (2003) Changes in physical activity and short-term changes in health care charges: a prospective cohort study of older adults. Prev Med 37:319–326CrossRefPubMed
Miller V, Ernst C, Collin F (1999) Smoking attributable medical care costs in the USA. Soc Sci Med 4:375–391CrossRef
Oberg M, Jaakkola MS, Prüss-Ustün A, Schweizer C, Woodward A (2010) Second-hand smoke: assessing the environmental burden of disease at national and local levels. World Health Organization, Environmental Burden of Disease Series, No. 18, Geneva
Rehm J, Baliunas D, Brochu S, Fischer B, Gnam W, Patra J, Popova S, Sarnocinska-Hart A, Taylor B (2006) The costs of substance abuse in Canada 2002. Canadian Centre on Substance Abuse, Ottawa, Canada
Sari N (2009) Physical inactivity and its impact on healthcare utilization. Health Econ 18:885–901CrossRefPubMed
Single E, Robson L, Xie X, Rehm J (1996) The costs of substance abuse in Canada. Canadian Centre on Substance Abuse, Toronto
Winkelmann R (2008) Econometric analysis of count data, 5th edn. Springer-Verlag, Berlin
World Bank (1999) Curbing the epidemic: governments and the economics of tobacco control. The World Bank, WashingtonCrossRef
Metadata
Title
Disparities in health care utilization by smoking status in Canada
Authors
Sunday Azagba
Mesbah Fathy Sharaf
Christina Xiao Liu
Publication date
01-12-2013
Publisher
Springer Basel
Published in
International Journal of Public Health / Issue 6/2013
Print ISSN: 1661-8556
Electronic ISSN: 1661-8564
DOI
https://doi.org/10.1007/s00038-013-0452-7

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