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暴露于自然寒冷和炎热环境:2004-2005 年美国医疗保险索赔中的体温过低和体温过高。

Exposure to natural cold and heat: hypothermia and hyperthermia Medicare claims, United States, 2004-2005.

机构信息

Division of Environmental Hazards and Health Effects, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA.

出版信息

Am J Public Health. 2012 Apr;102(4):e11-8. doi: 10.2105/AJPH.2011.300557. Epub 2012 Feb 16.

Abstract

OBJECTIVES

We measured the burden of hypothermia- and hyperthermia-related health care visits, identified risk factors, and determined the health care costs associated with environmental heat or cold exposure among Medicare beneficiaries.

METHODS

We obtained Medicare fee-for-service claims data of inpatient and outpatient health care visits for hypothermia and hyperthermia from 2004 to 2005. We examined the distribution and differences of visits by age, sex, race, geographic regions, and direct costs. We estimated rate ratios to determine risk factors.

RESULTS

Hyperthermia-related visits (n = 10,007) were more frequent than hypothermia-related visits (n = 8761) for both years. However, hypothermia-related visits resulted in more deaths (359 vs 42), higher mortality rates (0.50 per 100,000 vs 0.06 per 100,000), higher inpatient rates (5.29 per 100,000 vs 1.76 per 100,000), longer hospital stays (median days = 4 vs 2), and higher total health care costs ($98 million vs $36 million).

CONCLUSIONS

This study highlighted the magnitude of these preventable conditions among older adults and disabled persons and the burden on the Medicare system. These results can help target public education and preparedness activities for extreme weather events.

摘要

目的

我们测量了与体温过低和体温过高相关的医疗保健就诊负担,确定了相关风险因素,并确定了医疗保险受益人与环境热或冷暴露相关的医疗保健费用。

方法

我们从 2004 年至 2005 年获得了医疗保险按服务收费的住院和门诊体温过低和体温过高就诊的索赔数据。我们检查了按年龄、性别、种族、地理位置和直接成本就诊的分布和差异。我们估计了比率比来确定风险因素。

结果

在这两年中,与体温过高相关的就诊(n = 10,007)比与体温过低相关的就诊(n = 8761)更为常见。然而,体温过低相关的就诊导致更多的死亡(359 例比 42 例),更高的死亡率(每 10 万人 0.50 例比每 10 万人 0.06 例),更高的住院率(每 10 万人 5.29 例比每 10 万人 1.76 例),更长的住院时间(中位数天数= 4 天比 2 天)和更高的总医疗保健费用(9800 万美元比 3600 万美元)。

结论

本研究强调了这些可预防的疾病在老年人和残疾人中的严重程度以及对医疗保险系统的负担。这些结果可以帮助针对极端天气事件开展公众教育和准备活动。

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