This study attempted to evaluate the impact of household environmental tobacco smoke (ETS) to medical expenditures with the econometric model (four-part model), using the declarative files of the national health insurance between 1998 and 2004 year.
According to the purpose of this study, the dependent variable is the medical expenditures, including outpatient expenditures, inpatient expenditures and total medical expenditures. The accumulative exposure of household environmental tobacco smoke and the accumulative exposure of tobacco use are explained variables in this study. This study measured the individual exposure of household environmental tobacco smoke through subtract individual lifetime uptake of tobacco use from household lifetime uptake of tobacco use. “The pack” is the calculative unit of ETS exposure in this study. Age, sex, education year, family size, family income and health status are control variables in this study. For the purpose of calculate the marginal effects of household environmental tobacco smoke to medical expenditures, this study evaluated the impact of household environmental tobacco smoke to health status with two stage least square regression (2SLS) first.
We could find the main effect of the environmental tobacco smoke to medical expenditures is indirect through the change of health status, and the direct effect of the environmental tobacco smoke to medical expenditures is not strong. The final calculation, one-pack-tobacco exposure of the environmental tobacco smoke caused an increase of NT 6.95 of medical expenditures in seven years, and one-pack-tobacco exposure caused an increase of NT 1.54 of medical expenditures in seven years. The impact of environmental tobacco smoke to medical expenditures doubled over that of active tobacco use.
