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Healthcare resources attributable to child tobacco smoke exposure

Ashley L Merianos1,2, Roman A Jandarov3, Judith S Gordon4

  • 1School of Human Services, University of Cincinnati, Cincinnati, Ohio, United States of America.

Plos One
|February 23, 2021
PubMed

Insights

Children exposed to tobacco smoke face higher healthcare costs and utilization, including more urgent care visits and hospital admissions. Early tobacco control interventions in pediatric emergency departments can reduce these preventable acute care visits.

Area of Science:

  • Pediatric Healthcare Utilization
  • Environmental Health
  • Public Health Economics

Background:

  • Tobacco smoke exposure (TSE) significantly impacts the U.S. healthcare system.
  • A notable gap exists in understanding healthcare costs and utilization for pediatric emergency department (ED) and urgent care visits among children exposed to tobacco smoke.
  • This study addresses the need to assess healthcare utilization and costs in relation to pediatric TSE.

Purpose of the Study:

  • To longitudinally assess pediatric emergency department (ED) visits, urgent care visits, and hospital admissions.
  • To compare baseline visit costs between children exposed to tobacco smoke (TSE group) and unexposed children (non-TSE group).
  • To identify the economic and utilization burden of pediatric TSE on the healthcare system.

Main Methods:

  • A retrospective study utilizing electronic medical records of children aged 0-17 years.
  • Propensity score matching (nearest neighbor) was used to compare 380 children in the TSE group with 1,140 in the non-TSE group.
  • Linear and Poisson regression models were employed to analyze healthcare utilization and costs.

Main Results:

  • The percentage of children with at least one urgent care visit was higher in the TSE group (52.4%) compared to the non-TSE group (45.1%, p=0.01).
  • Children in the TSE group incurred higher baseline pediatric ED visit costs ($1,136.97) than the non-TSE group ($1,018.96, p=0.01).
  • The TSE group exhibited higher mean hospital admissions (0.12 vs. 0.06, p=0.02) and an 85% increased risk of hospital admissions (p=0.003).

Conclusions:

  • Pediatric patients exposed to tobacco smoke demonstrate increased urgent care utilization and hospital admissions over a 12-month period.
  • Higher baseline pediatric ED visit costs were observed in the tobacco smoke-exposed group.
  • Integrating tobacco control interventions during pediatric ED visits and urgent care encounters presents an opportunity to reduce preventable acute care utilization.
Abstract

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