title: Alcohol consumption, smoking and overweight as a burden for health care services utilization: a cross-sectional study in Estonia.
abstract: BACKGROUND
  Alcohol consumption, smoking and weight problems are common risk factors for different health problems. We examine how these risk factors are associated with the use of health care services.
  
  
  METHODS
  Data for 6500 individuals in the 25-64 age group came from three cross-sectional postal surveys conducted in 2004, 2006, and 2008 in Estonia. The effect of alcohol consumption, smoking and weight problems on the use of primary and specialist care services, hospitalizations and ambulance calls was analysed separately for men and women by using binary logistic regression.
  
  
  RESULTS
  Overweight and/or obesity were strongly related to the use of primary care and out-patient specialist services for both genders, and to hospitalizations and ambulance calls for women. Current smoking was related to ambulance calls for both genders, whereas smoking in the past was related to the use of primary care and specialist services among men and to hospitalizations among women. Beer drinking was negatively associated with all types of health care services and similar association was found between wine drinking and hospitalizations. Wine drinking was positively related to specialist visits. The frequent drinking of strong alcohol led to an increased risk for ambulance calls. Drinking light alcoholic drinks was positively associated with all types of health care services (except ambulance calls) among men and with the use of specialist services among women.
  
  
  CONCLUSIONS
  Overweight and smoking had the largest impact on health care utilization in Estonia. Considering the high prevalence of these behavioural risk factors, health policies should prioritize preventive programs that promote healthy lifestyles in order to decrease the disease burden and to reduce health care costs.
authors: Department of Public Health, University of Tartu, Ravila 19, Tartu 50411, Estonia. kaire.vals@tai.ee
authors: Kaire
authors: K
authors: Vals
authors: Raul-Allan
authors: RA
authors: Kiivet
authors: Mall
authors: M
authors: Leinsalu
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology*; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D004957:Estonia / Q000453:epidemiology; D005260:Female; D019538:Health Care Surveys; D006296:Health Services / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D050177:Overweight / Q000453:epidemiology*; D012907:Smoking / Q000453:epidemiology*
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