Yamamoto W, Masaki M, Nakamura K
Department of Hygiene and Preventive Medicine, Showa University School of Medicine.
Nihon Koshu Eisei Zasshi. 1996 Aug;43(8):597-605.
An analysis was made to elucidate influence of smoking habits on medical care expense. Subjects were 4,795 male workers aged 40 to 73 who participated in the routine medical check-up in 1988 at a health insurance society in Tokyo. Their daily habits including smoking habit were also surveyed. Data on medical care utilization were derived from the medical records for 1989 provided by the health insurance society. The data on medical care fees were examined, and hospitalization costs analyzed separately. Compared to other subjects, ex-smokers had a higher frequency of having a history of medical care. Ex-smokers showed higher and current smokers lower values of both visiting (percentage of subjects utilizing medical facilities at least once a year) and monthly rate of receiving examinations when compared to non-smokers. Current smokers had the lowest average number of days utilized for medical services, lowest average medical care fee per visit and annual medical care fee per person. The average number of days utilized and annual medical care fee per person was weakly correlated to smoking index. Ex-smokers had the highest average medical care fee per visit. There was a weak correlation to smoking index. Annual medical care fees per person decreased with age in non-smokers, but not in current smokers whose total fees were generally already low. In ex-smokers, fees increased until age fifties. From these results it would be difficult to identify on increase of medical care fees in middle-aged current smokers, especially in active businessmen. While the effect of smoking on health were still subclinical, average medical care fee per visit relate to and reflect the health effects of smoking.
为阐明吸烟习惯对医疗费用的影响进行了一项分析。研究对象为4795名年龄在40至73岁之间的男性工人，他们于1988年在东京的一家健康保险协会参加了定期体检。还调查了他们包括吸烟习惯在内的日常习惯。医疗服务利用数据来自健康保险协会提供的1989年医疗记录。对医疗费用数据进行了检查，并分别分析了住院费用。与其他受试者相比，戒烟者有医疗史的频率更高。与不吸烟者相比，戒烟者的就诊率（每年至少使用一次医疗设施的受试者百分比）和每月接受检查率更高，而当前吸烟者则更低。当前吸烟者的医疗服务平均使用天数最少，每次就诊的平均医疗费用和每人每年的医疗费用最低。医疗服务平均使用天数和每人每年的医疗费用与吸烟指数呈弱相关。戒烟者每次就诊的平均医疗费用最高。与吸烟指数呈弱相关。不吸烟者每人每年的医疗费用随年龄增长而降低，但当前吸烟者并非如此，他们的总费用通常已经很低。在戒烟者中，费用在五十多岁之前会增加。从这些结果来看，很难确定中年当前吸烟者尤其是活跃商人的医疗费用是否增加。虽然吸烟对健康的影响仍处于亚临床阶段，但每次就诊的平均医疗费用与吸烟对健康的影响相关并反映了这种影响。
