Miller L S, Zhang X, Rice D P, Max W
School of Social Welfare, University of California at Berkeley 94720, USA.
Public Health Rep. 1998 Sep-Oct;113(5):447-58.
To estimate state-by-state totals of medical expenditures attributable to cigarette smoking for calendar year 1993.
The smoking-attributable fractions (SAFs) of total state medical expenditures, by type of expenditure, were estimated using a national model that describes the relationship between smoking and medical expenditures, controlling for a variety of sociodemographic, economic, and behavioral factors. Employing data from the Behavioral Risk Factor Surveillance System, the authors used the national model to estimate SAFs for the 50 states and the District of Columbia, then applied these SAFs to published state medical expenditures, by type of expenditures, to estimate total 1993 state medical expenditures attributable to smoking. National estimates are the sums of state estimates.
In 1993, the estimated proportion of total medical expenditures attributable to smoking for the U.S. as a whole was 11.8%, with a range across states from 6.6% to 14.1%. By type of expenditure, SAFs ranged from a low of 8.0% for home health expenditures to a high of 15.9% for nursing home expenditures for the nation as a whole. Total U.S. medical expenditures attributable to smoking amounted to an estimated $72.7 billion in 1993 (95% interval estimate $48.0-$97.4 billion). Estimates of total smoking-attributable state medical expenditures (SAEs) ranged from $79.6 million to $8.72 billion.
Cigarette smoking accounted for a substantial portion of state and national medical expenditures in 1993, with considerable variation among states. The range across states was due to differences in smoking prevalence, health status, other socioeconomic variables used in the model, and the magnitude and patterns of state medical expenditures.
估算1993日历年各州因吸烟导致的医疗支出总额。
使用一个描述吸烟与医疗支出之间关系的全国模型，控制各种社会人口、经济和行为因素，按支出类型估算各州医疗总支出中归因于吸烟的比例（SAF）。作者利用行为风险因素监测系统的数据，使用全国模型估算了50个州和哥伦比亚特区的SAF，然后将这些SAF应用于已公布的按支出类型划分的各州医疗支出，以估算1993年各州因吸烟导致的医疗支出总额。全国估算值是各州估算值的总和。
1993年，美国整体上因吸烟导致的医疗支出估计比例为11.8%，各州范围在6.6%至14.1%之间。按支出类型划分，全国范围内SAF从家庭保健支出的8.0%的低点到疗养院支出的15.9%的高点不等。1993年美国因吸烟导致的医疗支出总额估计为727亿美元（95%区间估计为480亿至974亿美元）。各州因吸烟导致的医疗支出（SAE）估计范围从7960万美元到87.2亿美元不等。
1993年，吸烟占各州和全国医疗支出的很大一部分，各州之间存在相当大的差异。各州之间的差异是由于吸烟率、健康状况、模型中使用的其他社会经济变量以及各州医疗支出的规模和模式不同。
