Search resultsThe association of tobacco and alcohol consumption with the use of health care services in Spain
Title
The association of tobacco and alcohol consumption with the use of health care services in Spain
Publication type
Journal Article
Year of Publication
2000
Authors
Journal
Preventive Medicine
Volume
31
Issue
5
Pagination
554 - 561
Date published
2000
ISBN
00917435 (ISSN)
Keywords
Adolescent, Adult, Aged, alcohol, alcohol consumption, Alcohol Drinking, ambulatory care, article, emergency health service, Emergency Service, Hospital, Female, Health care services, health care utilization, health service, Health Services, Health Surveys, hospitalization, human, Humans, major clinical study, male, Odds Ratio, priority journal, smoking, smoking cessation, Spain, tobacco
Abstract
Background. Information on the impact of tobacco and alcohol consumption on the use of health services is scant and partially inconsistent. This paper examines the relationship between tobacco and alcohol consumption and the use of health care services in Spain. Methods. Data were drawn from the 1993 Spanish National Health Survey, covering a random 21,120-person representative sample of Spain's noninstitutionalized population ages 16 years and older. Information was obtained through home-based interviews. Results. Compared with never smokers, male smokers of more than 20 cigarettes/day tend to be hospitalized more frequently (odds ratio (OR) 1.31; 95% confidence limits (CL) 0.89-1.93) and make greater use of hospital emergencies (OR 1.51; 95%CL 1.13-2.01; P < 0.01). Among female smokers of more than 20 cigarettes/day, hospitalizations (OR 1.62; 95%CL 0.80-3.26) and medical visits (OR 1.35; 95%CL 0.79-2.30) are also higher than among never smokers, although the associations do not reach statistical significance. Compared with never smokers, ex-smokers of both sexes make greater use of health care services (P < 0.01 for most services). There is a negative dose-response relationship (P < 0.001) between alcohol consumption and utilization of hospital and ambulatory services, for both sexes. Results are reasonably consistent across all age groups and are observed after adjustment for the principal confounding factors. We have found no evidence of a tobacco-alcohol interaction with the use of health care services. Conclusions. Smokers and ex-smokers make greater use of health care services. Control of smoking might reduce the use of such services and the ensuing human and economic costs. However, as alcohol consumption increases, the use of health care services decreases. This finding should not be used to promote even the moderate consumption of alcoholic drinks. (C) 2000 American Health Foundation and Academic Press.