Smoking attributable medical expenditures, years of potential life lost, and the cost of premature death in Taiwan

Institute of Health Care Organization Administration, National Taiwan University, Taipei, Taiwan.
Tobacco control (Impact Factor: 5.93). 07/2005; 14 Suppl 1(suppl 1):i62-70. DOI: 10.1136/tc.2004.007963
Source: PubMed


To estimate the smoking attributable medical expenditures and productivity loss of people aged 35 and over in Taiwan in 2001 from a societal viewpoint.
A prevalence based approach was used to estimate smoking attributable costs. Epidemiological parameters were obtained from two follow up studies and government statistics. Data on medical care utilisation and expenditure were extracted from the National Health Insurance claim data.
Total smoking attributable medical expenditures (SAEs) amounted to USD 397.6 million, which accounted for 6.8% of the total medical expenditures for people aged 35 and over. Mean annual medical expenditures per smoker was USD 70 more than that of each non-smoker. Smoking attributable years of potential life lost (YPLL) totalled to 217,761 years for males and 15,462 years for females, and the corresponding productivity loss was USD 1371 million for males and USD 18.7 million for females.
Medical expenditures attributable to smoking accounted for 6.8% of the total medical expenditure of people aged 35 and over for the year 2001 in Taiwan. Corresponding YPLL and productivity loss also demand that actions be taken to fight cigarette smoking.

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    • "This figure is lower than previously published estimates of 102.1% in Hong-Kong [45]. 102.5% in the USA [46], 107.5% in Germany [47], 113.2% in California [48] 135% in Taiwan [49], 161% in China in 2000 [50] and 273% in China in 2008 [51]. "
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    ABSTRACT: Tobacco use is the single most preventable cause of death, incurring huge resource costs in terms of treating morbidity and lost productivity. This paper estimates smoking attributable mortality (SAM) as health costs in 2014 in Israel. Longitudinal data on prevalence of smokers and ex-smokers were combined with diagnostic and gender specific data on Relative Risks (RR) to gender and disease specific population attributable risks (PAR). PAR was then applied to mortality and hospitalization data from 2011, adjusted by population growth to 2014 to calculate SAM and hospitalization days (SAHD) caused by active smoking. These were used as a base for calculating deaths, hospital days and costs attributable to passive smoking, smoking by pregnant women, residential fires and productivity losses based on international literature. The lagged model estimated active SAM in Israel in 2014 to be 7,025 deaths. Cardio-vascular causes accounted for 45.0% of SAM, malignant neoplasms (39.2%) and respiratory diseases (15.5%). Lung cancer alone accounted for 24.1% of SAM. There were an estimated 793, 17 and 12 deaths from passive smoking, mothers-to-be smoking and residential fires. Total SAM is around 7,847 deaths (95% CI 7,698-7,997) in 2014. We estimated 319,231 active SAHD days (95% CI 313,135-325,326). Respiratory care accounted for around one-half of active SAHD (50.5%). Cardio-Vascular causes for 33.5% and malignant neoplasms (13.2%). Lung cancer only for 4.6%. Total SAHD was around 356,601 days including 36,049 days from passive smoking. Estimated direct acute care costs of 356,601 days in a general hospital amount to around 849 (95% CI 832–865) million NIS ($244 million). Non acute care costs amount to an additional 830 million NIS ($238 million). The total health service costs amount to 1,678 million NIS (95% CI 1,646-1,710) or $482 million, 0.2% of GNP. Productivity losses account for a further 1,909 million NIS ($548 million), giving an overall smoking related cost of 3,587 million NIS (95% CI 3,519-3,656) or $1,030 million, 0.41% of GNP). Smoking causes a considerable burden in Israel, both in terms of the expected 7,847 lives lost and the financial costs of around 3.6 million NIS ($1,030 million or 0.42% of GNP).
    Israel Journal of Health Policy Research 08/2014; 3(1):28. DOI:10.1186/2045-4015-3-28
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    • "Also, this analysis limited its scope to those 35 years old and older, as most of the cumulative hazardous effects of smoking-related cancers are unlikely to manifest in individuals younger than middle age (Ha et al., 2003; Kang et al., 2003; Lee et al., 2006). The smoking-attributable fraction (SAF) was calculated using the prevalence rate of current smoking, the prevalence rate of former smokers and the nonsmoking rate (Levin, 1953; Yang et al., 2005) according to the following formula: "
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    ABSTRACT: Cigarette smoking is one of the most important public health concerns in Korea and worldwide. A number of studies have been conducted to measure the health and economic burden of smoking, but these did not reflect recent changes such as the decrease in smoking rate and the increase in the incidence of cancer. The purpose of this study was to provide up-to-date estimates of the health and economic burden of cancer caused by smoking and to compare the results with those of previous studies. Cancer-related burden was assessed with nationally representative data such as claims data from the National Health Insurance Corporation, and cause of death records from the National Statistical Office and the Korea Health Panel. We determined the smoking-attributable burden by multiplying the smoking-attributable fraction by the total burden. As a result, the burden of major cancers due to smoking was found to be substantial despite a recent sharp decrease in smoking by the Korean population. The total economic cost reaches $2,234.0 million in males and $870.0 million in females. Also, the health burden of cancers due to smoking is 2,038.9 disability adjusted life years (DALYs) per 100,000 individuals in men and 732.2 DALYs per 100,000 individuals in women. Among all cancers, cancers of the trachea, lungs and bronchus are the leading causes of health and economic burden. The huge burden caused by cancers linked to smoking makes it imperative that adequate policies to decrease the prevalence of smoking be developed, particularly considering the recent increase in smoking rate among women.
    Asian Pacific journal of cancer prevention: APJCP 04/2012; 13(4):1525-31. DOI:10.7314/APJCP.2012.13.4.1525 · 2.51 Impact Factor
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    • "Some medical research shows that smoking leads to lung cancer, laryngeal cancer, asthma, and cardiovascular diseases [16, 17, 26–29]. Compared to those who do not smoke, smokers have shorter life expectancy and incur higher medical expenditure [14] [16] [19] [29] [30], and the people who are affected by secondhand smoke also tend to incur higher medical expenditure [25] [31]. Moreover, although appropriate drinking does no harm personal health [32] [33] [34] [35], excessive drinking increases the numbers of accidents and the morbidity of liver cancer. "
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    ABSTRACT: We investigate the effect of different scales of addictive factors on the utilization of medical services in this paper using a two-part model. Data are from the 2005 National Health Interview Survey and the claims data in the National Health Insurance Research Database in Taiwan. The results show that personal addictive behavior is significantly associated with both outpatient and inpatient utilization. Moreover, our result implies that those who smoked at least 20 cigarettes per day might not visit a doctor until the illness was severe. It suggests that the government can accomplish these goals by promotion and education in order to increase public awareness of personal health.
    01/2012; 2012(2090-2123). DOI:10.1155/2012/801204
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