Emergency presentations and associated costs by patient smoking status in Queensland

Objective To analyse Queensland statewide emergency department (ED) presentations and associated cost per adult, and assess whether there are differences by smoking status. Methods Data were from a cross-sectional, population-based survey linked to various administrative data, retrospectively and prospectively, with ED presentations and the associated cost as the main outcomes. Survey-weighted generalised linear models were used to control for measured confounders. Results Data were available for 21,202 adults surveyed from the general population, linked to 9411 ED presentations in the 12 months following survey participation. Overall, 19.0% of participants had at least one ED presentation. A higher proportion of current smokers presented to the ED (26.3%) compared with ex-smokers (19.6%) and never smokers (16.8%). A similar pattern was observed for three or more ED presentations (smokers 8.1%; ex-smokers 4.9%; never smokers 3.5%). The mean annual government cost for ED services was A$284.20 per adult (95% CI: A$271.24–A$298.77) and was nearly double for current smokers (A$435.26; 95% CI: A$390.68–A$480.89) than for never smokers (A$226.75; 95% CI: A$211.86–A$242.90). In a hypothetical scenario where nobody had smoked, meaningful reductions in ED healthcare resources could be achieved. Conclusions Current smokers have higher ED presentation rates than people who previously or never smoked. Potential cost savings could be realised and reallocated for other health care, such as prevention, if the disparity by smoking status was removed.