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Int. J. Environ. Res. Public Health 2018, 15(3), 425; https://doi.org/10.3390/ijerph15030425

The Impact of Ambient Air Pollution on Daily Hospital Visits for Various Respiratory Diseases and the Relevant Medical Expenditures in Shanghai, China

1
Department of Public Administration, School of Economics and Management, Tongji University, Tongji Building A, 1500 Siping Road, Shanghai 200092, China
2
Department of Environmental Health, School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, Fudan University, P.O. Box 249, 130 Dong-An Road, Shanghai 200032, China
3
Shanghai Key Laboratory of Meteorology and Health, Shanghai 200030, China
*
Authors to whom correspondence should be addressed.
Received: 5 January 2018 / Revised: 26 February 2018 / Accepted: 26 February 2018 / Published: 28 February 2018
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Abstract

The evidence concerning the acute effects of ambient air pollution on various respiratory diseases was limited in China, and the attributable medical expenditures were largely unknown. From 2013 to 2015, we collected data on the daily visits to the emergency- and outpatient-department for five main respiratory diseases and their medical expenditures in Shanghai, China. We used the overdispersed generalized additive model together with distributed lag models to fit the associations of criteria air pollutants with hospital visits, and used the linear models to fit the associations with medical expenditures. Generally, we observed significant increments in emergency visits (8.81–17.26%) and corresponding expenditures (0.33–25.81%) for pediatric respiratory diseases, upper respiratory infection (URI), and chronic obstructive pulmonary disease (COPD) for an interquartile range increase of air pollutant concentrations over four lag days. As a comparison, there were significant but smaller increments in outpatient visits (1.36–4.52%) and expenditures (1.38–3.18%) for pediatric respiratory diseases and upper respiratory infection (URI). No meaningful changes were observed for asthma and lower respiratory infection. Our study suggested that short-term exposure to outdoor air pollution may induce the occurrences or exacerbation of pediatric respiratory diseases, URI, and COPD, leading to considerable medical expenditures upon the patients. View Full-Text
Keywords: air pollution; respiratory diseases; emergency-room visits; outpatient visits; expenditures air pollution; respiratory diseases; emergency-room visits; outpatient visits; expenditures
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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).
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Zhang, H.; Niu, Y.; Yao, Y.; Chen, R.; Zhou, X.; Kan, H. The Impact of Ambient Air Pollution on Daily Hospital Visits for Various Respiratory Diseases and the Relevant Medical Expenditures in Shanghai, China. Int. J. Environ. Res. Public Health 2018, 15, 425.

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