Medicaid expenditures for children living with smokers
1 Mongan Institute for Health Policy, Massachusetts General Hospital, Boston, Massachusetts, USA
2 Tobacco Research and Treatment Center, General Medicine Division, Massachusetts General Hospital, Boston, Massachusetts, USA
3 Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA
4 MGH Center for Child and Adolescent Health Policy, General Pediatrics Division, MassGeneral Hospital for Children, Boston, Massachusetts, USA
5 Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA
BMC Health Services Research 2011, 11:125 doi:10.1186/1472-6963-11-125Published: 25 May 2011
Children'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.
Data 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.
Children 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.
Living 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.