Florence Curtis S, Adams E Kathleen, Ayadi M Femi
Rollins School of Public Health at Emory University in Atlanta, GA, USA.
J Health Care Finance. 2007 Fall;34(1):36-43.
Estimates of the excess health care costs from the exposure of children to tobacco smoke are not available in the United States. We use two nationally representative databases and current econometric techniques to estimate annual health care costs attributable to secondhand exposure by adults in the household. The point estimate closest to significance (p = .11) indicates annual smoking attributable costs equal $890 in 2003 dollars and approximately 2 percent of total annual neonatal and pediatric health care costs. Our inability to find a statistically significant effect appears driven by the negative relationship found between the child's exposure and any use/expense for the child. Unobserved caregiver characteristics are likely to be positively associated with smoking but negatively associated with children's health care utilization. This is consistent with evidence from observational studies that indicate adult smokers' lower orientation toward preventive care contributes to a decreased use of discretionary health services.
在美国，尚无关于儿童接触烟草烟雾所产生的额外医疗保健费用的估算数据。我们使用两个具有全国代表性的数据库和当前的计量经济学技术，来估算因家庭中成年人二手烟暴露而产生的年度医疗保健费用。最接近显著性水平（p = 0.11）的点估计表明，2003年美元价值下，每年因吸烟产生的费用为890美元，约占年度新生儿和儿科医疗保健总费用的2%。我们未能发现具有统计学显著性的影响，这似乎是由儿童接触与儿童的任何使用/费用之间的负相关关系所驱动的。未观察到的照顾者特征可能与吸烟呈正相关，但与儿童的医疗保健利用率呈负相关。这与观察性研究的证据一致，这些研究表明成年吸烟者对预防性保健的关注度较低，导致可自由支配的医疗服务使用减少。
