Medicaid expenditures for children living with smokersReport as inadecuate

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BMC Health Services Research

, 11:125

Utilization, expenditure, economics and financing systems


BackgroundChildren-s exposure to secondhand smoke is associated with increased morbidity. We estimated Medicaid expenditures for children living with smokers compared to those living with no smokers in the United States.

MethodsData were overall and service-specific i.e., inpatient, ambulatory, emergency department, prescription drug, and dental annual Medicaid expenditures for children 0-11 years old from the 2000-2007 Medical Expenditures Panel Surveys. Smokers- presence in households was determined by adult respondents- self reports. There were 25,835 person-years of observation. We used multivariate analyses to adjust for child, parent, and geographic characteristics.

ResultsChildren with Medicaid expenditures were nearly twice as likely to live with a smoker as other children in the U.S. population. Adjusted analyses revealed no detectable differences in children-s overall Medicaid expenditures by presence of smokers in the household. Medicaid children who lived with smokers on average had $10 95% CI $3, $18 higher emergency department expenditures per year than those living with no smokers.

ConclusionsLiving with at least one smoker a proxy for secondhand smoke exposure is unrelated to children-s overall short-term Medicaid expenditures, but has a modest impact on emergency department expenditures. Additional research is necessary to understand the relationship between secondhand smoke exposure and long-term health and economic outcomes.

List of AbbreviationsSHSSecondhand smoke

CHIPChildren-s Health Insurance Program

MEPSMedical Expenditures Panel Survey

AHRQAgency for Healthcare Research and Quality

NMESNational Medical Expenditures Survey

Electronic supplementary materialThe online version of this article doi:10.1186-1472-6963-11-125 contains supplementary material, which is available to authorized users.

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Author: Douglas E Levy - Nancy A Rigotti - Jonathan P Winickoff



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