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Estimating the healthcare costs of children born to pregnant smokers in England : cohort study using primary and secondary healthcare data
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Vaz, L. R., Jones, M. J., Szatkowksi, L., Tata, L. J., Petrou, Stavros and Coleman, Tim (2018) Estimating the healthcare costs of children born to pregnant smokers in England : cohort study using primary and secondary healthcare data. Addiction, 113 (7). pp. 1305-1316. doi:10.1111/add.14183 ISSN 0965-2140.
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Official URL: http://doi.org/10.1111/add.14183
Abstract
Background and aims
Little is known about the long-term economic consequences of smoking during pregnancy. We estimated the association between smoking in pregnancy and the costs of delivering health-care to infants and children in England, and investigated which aspects of care are the key drivers of these costs.
Methods
We used Hospital Episode Statistics (HES) linked with Clinical Practice Research Datalink (CPRD) data in England from January 2003 to January 2015 in children with longitudinal data for at least 1, 5 and 10 years after birth. Poisson regression provided rate ratios (RR) and 95% confidence intervals (CIs) comparing health-care episode rates between those exposed and not exposed to smoking during pregnancy. Linear regression was used to compare estimated costs between groups (£ sterling, 2015 prices) and generalized linear multivariable (GLM) models adjusted for potentially moderating factors.
Results
A total of 93 152 singleton pregnancies with the required data were identified. Maternal smoking in pregnancy was associated with higher primary care, prescription and hospital in-patient episode rates, but lower out-patient visit and diagnostic test rates. Adjusting for year of birth, socio-economic deprivation, parity, sex of child and delivery method showed that maternal smoking in pregnancy was associated with increased child health-care costs at 1 year [average cost difference for children of smokers, β = £91.18, 95% confidence interval (CI) = £47.52–134.83 and 5 years of age (β = £221.80, 95% CI = £17.78–425.83], but not at 10 years of age (β = £365.94, 95% CI = –£192.72 to £924.60).
Conclusion
In England, maternal smoking in pregnancy is associated with increased child health-care costs over the first 5 years of life; these costs are driven primarily by greater hospital in-patient care.
Item Type: | Journal Article | ||||||||||||||||||||||||
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Subjects: | R Medicine > RC Internal medicine | ||||||||||||||||||||||||
Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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Library of Congress Subject Headings (LCSH): | Pregnant women -- Tobacco use, Smoking -- Economic aspects, Medical economics, Medical care, Cost of, Regression analysis | ||||||||||||||||||||||||
Journal or Publication Title: | Addiction | ||||||||||||||||||||||||
Publisher: | Wiley-Blackwell Publishing Ltd. | ||||||||||||||||||||||||
ISSN: | 0965-2140 | ||||||||||||||||||||||||
Official Date: | July 2018 | ||||||||||||||||||||||||
Dates: |
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Volume: | 113 | ||||||||||||||||||||||||
Number: | 7 | ||||||||||||||||||||||||
Page Range: | pp. 1305-1316 | ||||||||||||||||||||||||
DOI: | 10.1111/add.14183 | ||||||||||||||||||||||||
Status: | Peer Reviewed | ||||||||||||||||||||||||
Publication Status: | Published | ||||||||||||||||||||||||
Access rights to Published version: | Open Access (Creative Commons) | ||||||||||||||||||||||||
Date of first compliant deposit: | 31 January 2018 | ||||||||||||||||||||||||
Date of first compliant Open Access: | 2 March 2019 | ||||||||||||||||||||||||
RIOXX Funder/Project Grant: |
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