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Disparities in health care utilization by smoking status in Canada

Abstract

Objectives

To examine the association between smoking status and the utilization of health care services in Canada.

Methods

The study uses data from the 2007 Canadian Community Health Survey, which contains information on the number of visits to general practitioner (GP), specialists (SP) and the number of nights spent in a hospital. The finite mixture estimation method is used in order to account for heterogeneity among smokers.

Results

Multivariate regression results indicate differential effects of smoking on health care utilization for at least two different groups of health care users: low and high users. In particular, we find that among the low-use group, smokers use less GP and SP services than never smokers. However, for the low-use and high-use groups, smokers have more hospitalizations than never smokers. The incidence of hospitalization is higher for the low-use group after controlling for need, socio-demographic characteristics and province fixed effects. Former smokers who recently quit use more health care services.

Conclusions

Tobacco consumption elevates the use of health care services, especially among the high-use group.

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Acknowledgments

We are grateful to an associate editor and three anonymous reviewers of this journal for their valuable comments and suggestions which substantially improved the paper. We are thankful to Nikolay Gospodinov, Ian Irvine and Gordon Fisher for useful comments and suggestions.

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Corresponding author

Correspondence to Sunday Azagba.

Appendix A: Negative binomial results

Appendix A: Negative binomial results

See Tables 8, 9, 10.

Table 8 General practitioner visits: regression results from the Canadian community health survey, 2007
Table 9 Specialist visits: Regression results from the Canadian community health survey, 2007
Table 10 Hospitalization: regression results from the Canadian Community Health Survey, 2007

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Azagba, S., Sharaf, M.F. & Xiao Liu, C. Disparities in health care utilization by smoking status in Canada. Int J Public Health 58, 913–925 (2013). https://doi.org/10.1007/s00038-013-0452-7

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Keywords

  • Smoking
  • Health care utilization
  • Unobserved heterogeneity
  • Finite mixture model
  • Canada