Abstract
Children exposed to secondhand smoke (SHS) are at increased risk for disease. We sought to estimate the medical costs among Korean children who were exposed to SHS at home. A Markov model was developed, including five diseases (asthma, acute otitis media, acute bronchitis, pneumonia and sudden infant death syndrome) that were significantly associated with SHS in children based on a systematic review. The time horizon of the analysis was 20 years (from birth to adulthood), and the cycle length was 1 week. The direct healthcare costs were discounted annually at 5%. Univariate and probabilistic sensitivity analyses were conducted. The Markov model estimated the healthcare costs for 20 years as 659.61 USD per exposed child, an increase of approximately 30% compared to the cost per unexposed child (507.32 USD). Sensitivity analysis suggested that the younger the age of the exposure, the greater the incremental healthcare costs incurred, implying that infants and young children were especially vulnerable to the SHS exposure. Findings of this study could provide key baseline data for future economic evaluations on SHS control policies in South Korea.
Highlights
Secondhand smoke (SHS) contributes to premature deaths and diseases in both adults and children [1]
Since there was no domestic study on incidence rate of the included diseases, incidence rates of AOM, acute bronchitis, and asthma were sourced from international studies [29,32,33]
The exact scope of the diseases included in the Hill et al (2008) study and our study is different and difficult to compare, the annual costs of secondhand smoke (SHS) exposure estimated by Hill et al (2008) were 117 USD, whereas our study found that the cost was 152.29 USD for 20 years
Summary
Secondhand smoke (SHS) contributes to premature deaths and diseases in both adults and children [1]. 40% of children, 33% of nonsmoker males, and 35% of nonsmoker females are exposed to SHS, resulting in more than 600,000 deaths in 2004 and accounting for 1% of the world’s mortality rate [2]. Compared with SHS-nonexposed children, SHS-exposed children tend to visit the emergency room more frequently and have a significantly higher length of hospital stay, resulting in higher healthcare costs [4]. There is no policy in most countries, including Korea, to regulate SHS at home where children, who are vulnerable to the adverse effects of SHS, spend most of their time [6]. In Korea, the SHS exposure rate in the home for
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