Department of Healthcare Economics and Quality Management, School of Public Health, Kyoto University Graduate School of Medicine, Yoshida Konoe-cho, Sakyo-ku, Kyoto, Japan.
Health Policy. 2010 Jan;94(1):84-9. doi: 10.1016/j.healthpol.2009.08.007. Epub 2009 Sep 22.
It is controversial whether smokers have higher lifetime medical expenditures than non-smokers, because smokers have high annual medical expenditures but comparatively short lives. We examined differences in lifetime medical expenditures between them.
We constructed life tables for male smokers and non-smokers from 40 years of age. We calculated average annual medical expenditures of them categorized by survivors and deceased, which were used to examine differences in lifetime medical expenditures between them and perform sensitivity analyses.
Smokers had a higher mortality rate, shorter life expectancy, and generally higher annual medical expenditures than non-smokers. We also observed tendencies for smokers to have higher inpatient expenditures, but non-smokers to have higher outpatient expenditures. Although non-smokers had lower long-term cumulative medical expenditures between 64 and 81 years of age, their lifetime medical expenditures were higher by a minimal amount. Sensitivity analyses did not change this result.
Smoking may not cause increases in lifetime medical expenditures because smokers had lower lifetime medical expenditures than non-smokers. However, it was clear that smokers, especially survivors, often had higher annual medical expenditures than non-smokers. The importance of tobacco control is still relevant.
吸烟者的终身医疗支出是否高于不吸烟者存在争议，因为吸烟者的年医疗支出高，但寿命相对较短。我们研究了他们之间终身医疗支出的差异。
我们从 40 岁起为男性吸烟者和不吸烟者构建生命表。我们计算了按幸存者和死亡者分类的他们的平均年度医疗支出，用于检查他们之间终身医疗支出的差异，并进行敏感性分析。
吸烟者的死亡率更高，预期寿命更短，年医疗支出普遍高于不吸烟者。我们还观察到吸烟者的住院支出较高，而非吸烟者的门诊支出较高。尽管非吸烟者在 64 至 81 岁之间的长期累积医疗支出较低，但他们的终身医疗支出仅略高。敏感性分析并未改变这一结果。
吸烟可能不会导致终身医疗支出增加，因为吸烟者的终身医疗支出低于不吸烟者。然而，吸烟者，尤其是幸存者，其年医疗支出往往高于不吸烟者，这一点是明确的。因此，控制烟草的重要性仍然相关。
