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. 2023 Aug 24:21:107.
doi: 10.18332/tid/169654. eCollection 2023.

Short-term effects of national smoking cessation service on smoking-related disease prevalence and healthcare costs: Experience from the National Health Insurance Service Smoking Cessation Intervention Program in Korea

Jin-Kyoung Oh  1 , Minji Han  2 , Min Kyung Lim  3
Affiliations

Short-term effects of national smoking cessation service on smoking-related disease prevalence and healthcare costs: Experience from the National Health Insurance Service Smoking Cessation Intervention Program in Korea

Jin-Kyoung Oh et al. Tob Induc Dis. .

Abstract

Introduction: We measured the short-term clinical and economic impacts of the National Health Insurance Service (NHIS) smoking cessation program, which subsidizes the cost of pharmacotherapy and medical consultations, by comparing the changes in prevalence and healthcare costs of smoking-related diseases among cessation service users, non-users, and never smokers.

Methods: Smokers who used the cessation service from 2015 to 2017 were included (n=779315). We used claims data from the NHIS, a mandatory, single-payer insurance covering the entire Korean population, to determine the number of patients with selected diseases, their healthcare utilization, and medical costs, and compared these amounts in the one year before and after enrollment. For further comparison, we also estimated disease prevalence and medical costs in matched controls by age, sex, income, and residential area, including never smokers and smokers who never used the cessation program.

Results: Across all 15 selected diseases, the number of patients, days spent in the hospital, and medical costs for 1 year were consistently higher after service enrollment than before. This pattern was observed for both men and women. Notably, decreased prevalence and medical costs for pneumonia were observed among individuals aged <50 years. Healthcare utilization for any kind of disease for 1 year was 97.7%, 91.1%, and 88.8% among cessation service users, never smokers, and smokers who did not use the cessation service, respectively. The disease-specific prevalence was also highest and increased more in the cessation service users compared with the control groups.

Conclusions: Cessation service users were more likely to seek healthcare. Increased healthcare utilization in the first year after cessation service use may have resulted from smoking-related conditions that led individuals to attempt smoking cessation.

Keywords: Korea; benefit; cessation; cost; smoking.

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Conflict of interest statement

The authors have each completed and submitted an ICMJE form for disclosure of potential conflicts of interest. The authors declare that they have no competing interests, financial or otherwise, related to the current work. All authors declare that since the initial planning of the work, financial support was provided by the Korean Ministry of Health and Welfare (11-1352000-002705-01) and NRF-2020R1A2C2012295.

Figures

Figure 1
Figure 1
Flow chart for selection of study population for comparing the diseases prevalence and the medical costs before and after enrollment in the National Health Insurance Service (NHIS) smoking cessation program
Figure 2
Figure 2
Selection of population in cases (National Health Insurance Service (NHIS) smoking cessation service users) and controls (smokers who did not use the service and never-smokers) for comparing the diseases prevalence and the medical costs between them
Figure 3
Figure 3
The prevalence of the five most common diseases in 2015 and 2017 among the National Health Insurance Service (NHIS) smoking cessation service users (service users), smokers who did not use the NHIS cessation service (smokers), and never smokers in 2016
See this image and copyright information in PMC

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