Health Care
Health Care Expenditures Attributable to Smoking
In the United States alone, there are about 440,000 individuals who die annually of smoking related diseases (Pubmed). According to the U.S Department of Health and Human Services, recent studies linked cigarette smoking to a numerous other diseases to include abdominal aortic aneurysm, acute myeloid leukemia, cataract, cervical cancer, kidney cancer, pancreatic cancer, pneumonia, periodontitis, and stomach cancer. “These are in addition to diseases previously known to be caused by smoking, including bladder, esophageal, laryngeal, lung, oral, and throat cancers, chronic lung diseases, coronary heat and cardiovascular diseases, as well as reproductive and sudden infant death syndrome” (U.S. Department of Health). This report indicated that exposure to cigarette smoke can harm almost every organ in the body. The increases in the number of cigarette smoking disease are directly proportional to the increase in the health care expenditure that is linked to smoking.
SMOKING AND RESPIRATORY DISEASE
Chronic Obstructive Pulmonary Disease. The damage caused by smoking in the airways and the small air sacs found in the lungs can result to lung cancer. Lung diseases may include Chronic Obstructive Pulmonary Disease (COPD) which is characterized by a progressive difficulty in breathing leading to oxygen deprivation of the body. In the United States, the health care system is well set up that COPD is now a curable disease. Prevention, however, is better than going through the long and costly treatment.
A methodological research published in 2010 shows the direct costs of chronic obstructive pulmonary disease on commercially insured individuals who received medical treatment on said disease. The costs used in the study was taken in 2006, indexed and adjusted to 2008 US dollars.
Of the 37,089 COPD patients included in the study, 53% were in the
outpatient cohort, 37% were in the urgent outpatient cohort, 3% were
in the ED cohort, and the standard admission and ICU cohorts
together comprised 6%. Mean (standard deviation, SD) annual COPD
related health care costs (2008 US$) increased across the cohorts
( P< 0.001), ranging from $2003 ($3238) to $43,461 ($76,159) per
patient. Medical costs comprised 96% of health care costs for the ICU
cohort. Adjusted mean (SD) episode-level costs were $305 ($310) for
an outpatient visit, $327 ($65) for an ED visit, $9745 ($2968) for a
standard admission and $33,440 for an ICU stay (Dalal, Chrsitensen, Liu, Riedel, 2010)
Non-Small-Cell Lung Carcinoma. Another lung disease that is commonly linked to cigarette smoke is the Nom-Small-Cell Lung Cancer. Its symptoms may include persistent cough that gets worse, accompanied by chest pain. The patient may also experience hoarseness or sudden voice changes, wheezing and weigh loss that resulted from loss of appetite. Symptoms of advanced staged NSCLC include pain in the bones, headache, dizziness and yellow skin or eyes. Suggested treatment may vary depending on severity of the disease (Lung). An examination of the cost related to the treatment of commercially insured cohort treated for NSCLC follows:
There were three hundred forty –nine patients who were diagnosed with the NSCLC. The average costs spent on one patient after diagnosis is $47,941 (with 95% confidence interval). For local diseases, total average cost is lower with average costs amounting to $37,514.21. The costs of hospital stay and hospital-based claims amounts to 48% and 70% of costs respectively. Persons who received medical treatment and survived in less than one year spent an average of $47,280 (Costs). The treatment of NSCLC may include radiation therapy, chemotherapy, surgical operation and radiofrequency ablation. Treatment may vary and is largely dependent on the stage of the cancer, overall health, and the possibility of curing the cancer.
SMOKING AND CARDIOVASCULAR DISEASES
According to research, those who smoke are likely to double their chance in incurring heart attack as compared to those who never smoke. Smokers supply their body with the dangerous carbon monoxide and carbon dioxide, while reducing the amount of oxygen circulated. As a result, the heart, lungs, and brain do not receive the needed amount to properly function.
Coronary artery Disease. The poisonous substances present in cigarette smoke can trigger Coronary Artery Disease. These substances can cause blood clot that may block the coronary arteries and may cause heart attack. Cigarette smoking can also reduce the blood circulation to the heart and may trigger irregular heartbeats. The following is a discussion on the cost of treating coronary heart disease:
Most of the values were mainly from national public-use databases. Initial years’ costs of treating CAD are estimated at $17,352 for fatal acute myocardial infarction, $15,540 for nonfatal AMI, $2,569 for stable angina, $12,058 for unstable angina, and $713 for sudden CAD death. Non-event associated direct costs of CAD medication are estimated to be $1,051 per year. The annual incidence of Cad in the United States is estimated at 616900 cases, with first year costs of treatment totaling $5.54 billion. Five- and 10-year collective costs in 1995 dollars for patients who were initially CAD free are roughly calculated at $9.2 billion and $16.5 billion, respectively; for all patients with CAD, these costs are estimated to be $71.5 billion and $126.6 billion, respectively (Russel, Huse, Drown, Hamel, and Hartz, 1998)
Stroke. Smoking is harmful for individuals who are suffering from high blood pressure. The risk is a five time likelihood of stroke than smokers who have normal blood pressure. The chemical content in cigarettes triggers the likelihood of blood clot on the arteries, making it difficult for oxygen to circulate in the body.
The costs associated with the medical treatment of stroke are a huge economic burden to the healthcare system. The cost of medical treatment is estimated to be at $30 billion annually, with 50% of it associated with direct medical costs. A research on the costs of treatment was taken from the national database sponsored by the Voluntary Hospitals of America. A total of 191 cases were taken in the research. Of that number, 114 had supratentorial and 67 had infratentorial strokes. Length of stay in the hospital ranged from 1 to 63 days with mortality of 3%. The range of hospital costs is $1,199 to 59,799 resulting to median costs of $4,408. In addition to the hospital costs in the preceding report is the physicians’ fee, which is estimated at $492 (Diringer, Edwards, Mattson, Akins, Sheedy, Hsu, Dromerick). There is an indication that medical costs went up in terms of the severity of the stroke, while age, insurance status have a little influence on the total costs (Diringer et al).
The research indicated that there was no direct relationship between age, insurance status, condition of the patient before the stroke and the total cost. The patients who were not able to survive have used more resources at $9754 compared to those who survived at $3961. Those who survived and allowed to nursing homes have greater medical costs at $8490, versus to that of those who went home at $3074. Help costs at home averaged at $4071, while the rehabilitation costs amounted to an average of $6611 (Diringer).
Lung Cancer. According to the American Lung Cancer, tobacco smoke is the leading cause of lung cancer. The disease is curable in its’ earlier staged, however, the symptoms associated with this disease are usually notable during the advance stage.
One research on the costs of medication associated with lung cancer was conducted on data taken from 1991 to 2003, with 60,231 individuals. The Surveillance, Epidemiology and End results are based on Medicare data are used to determine the approximate monthly and patient-liability expenses for clinical phases of lung cancer. The costs are estimated on the initial stage of diagnosis, until the termination of treatment. Costs were computed as the totality of the Medicare reimbursements, co- insurance, and the patient’s liability.
One result of the study shows that the treatment costs for 72-year-old patients, who were found to have lung cancer in year 2000, ranged from $2,687 (for those with no active treatment) to $9,360 (for individuals who have undergone chemo therapy). The patients’ obligation is about 21.6%of the total care costs and has increased from the year 1992-2003. Chemotherapy patients incurred the most expense that ranged from $1,617 to $2,004 monthly expense.
Research revealed that lung cancer is the most common cancer across United States, over 215,000 cases in year 2008. The treatment of this disease is approximately 20% of Medicare’s total expenses for cancer cases. In addition to that, individual burden on the expenses are also high. “Out-of-pocket spending exceeded 25% of annual income for low-income beneficiaries with cancer in 1995, and increased among all beneficiaries from 1997 to 2003” (Treatment)
Asthma. Although anyone can get asthma, and there are hereditary factors affecting its occurrence, the tendency of its development is also affected by environmental factors, such as exposure to cigarette smoke. There are an estimated 17 million Americans who have this illness. The costs of treating the disease in the United States alone amounted to around $19.7 billion annually. The emergency Department in many U.S hospitals is bombarded by as many as 1.81 million cases annually, with almost 500,000 of admitted for hospitalization.
Smoking increases the risk of developing asthma at any age. Cigarette smoke can be damaging to the lungs as the smoke irritates the airways. A swollen, narrow and mucus filled airways would often result to asthma flare up (Asthma). There are many diseases that are attributable to cigarette smoking. The tobacco smoke contains harmful chemicals and substances that can readily hurt the human body and diminish ones overall health and well-being. More than that, breathing in air that contains cigarette smoke can also be harmful. Cigarette smoking is known to cause numerous diseases as one can imagine. Cigarette smoke, according to studies, can cause and complicate diseases such as heart disease, stroke, aortic aneurysm, chronic obstructive pulmonary disease, asthma and even cataracts. Smokers are also at risks at developing pneumonia and other airway complications.
The costs of treating diseases associated with cigarette smoke can largely impact the medical bills. In the United States, medical treatment of the disease attributable to smoking is a tremendous economic burden. In addition to that, an individual and his family would have to suffer time lost in attending to the numerous treatment processes.
References
Asthma. American Lung Cancer Association. Retrieved from http://www.lung.org
Costs of Care Associated with NSLC in Commercially Insured Cohorts. Journal of Clinical Oncology. Retrieved from http://jco .ascopubs.org
Dala, A., Christensen, L., Liu, F., Rieda, A., Lung Cancer Treatment Costs. PMC. Retrieved from http://www.ncbi.nlm.nih.gov
Diringer, M., Edwards, D., Mattson, D., Akins, P., Sheedy, C., Hsu, C., Dromerick, A. Predictors of Acute Hospital Costs for treatment of Ischemic Stroke in an Academic Center. American Heart Stroke Association. Retrieved from http://stroke.ahajournals.org
Lung Cancer Health Center. WebMd. Retrieved from http://www.ncbi.nlm.nih.gov
Lung Cancer Treatment Costs, 1992 to 2003. Value in Health. Retrieved from http://www.sciencedirect.com
Russel,M., Huse, D., Drown, S. Hamel, E., Hartz, S., Direct Medical Costs of Coronary Artery Disease in the United States
U.S. Department of Health and Human Services. As cited in http://www.therapy_store.com
