能源价格与美国医院患者治疗结果之间的关联

Association Between Energy Prices and US Hospital Patient Outcomes.

作者信息

Brown Lawrence H, Chaiechi Taha, Buettner Petra G, Canyon Deon V

机构信息

From the Department of Surgery and Perioperative Care, Dell Medical School at the University of Texas-Austin, Austin, Texas, Discipline of Economics, School of Business, James Cook University, Cairns, Australia, Tropical Health Solutions Pty Ltd, Idalia, Australia, and the Daniel K. Inouye Asia Pacific Center for Security Studies, Honolulu, Hawaii.

出版信息

South Med J. 2017 Apr;110(4):257-264. doi: 10.14423/SMJ.0000000000000636.

DOI:10.14423/SMJ.0000000000000636

PMID:28376522

Abstract

OBJECTIVE

To evaluate associations between changing energy prices and US hospital patient outcomes.

METHODS

Generalized estimating equations were used to analyze relationships between changes in energy prices and subsequent changes in hospital patient outcomes measures for the years 2008 through 2014. Patient outcomes measures included 30-day acute myocardial infarction, heart failure, and pneumonia mortality rates, and 30-day acute myocardial infarction, heart failure, and pneumonia readmission rates. Energy price data included state average distillate fuel, electricity and natural gas prices, and the US average coal price. All of the price data were converted to 2014 dollars using Consumer Price Index multipliers.

RESULTS

There was a significant positive association between changes in coal price and both short-term ( = 0.029) and long-term ( = 0.017) changes in the 30-day heart failure mortality rate. There was a similar significant positive association between changes in coal price and both short-term ( <0.001) and long-term ( = 0.002) changes in the 30-day pneumonia mortality rate. Changes in coal prices also were positively associated with long-term changes in the 30-day myocardial infarction readmission rate ( < 0.001). Changes in coal prices ( = 0.20), natural gas prices ( = 0.040), and electricity prices ( = 0.040) were positively associated with long-term changes in the 30-day heart failure readmission rate.

CONCLUSIONS

Changing energy prices are associated with subsequent changes in hospital mortality and readmission measures. In light of these data, we encourage hospital, health system, and health policy leaders to pursue patient-support initiatives, energy conservation programs, and reimbursement policy strategies aimed at mitigating those effects.

摘要

目的

评估能源价格变化与美国医院患者预后之间的关联。

方法

采用广义估计方程分析2008年至2014年能源价格变化与医院患者预后指标后续变化之间的关系。患者预后指标包括30天急性心肌梗死、心力衰竭和肺炎死亡率，以及30天急性心肌梗死、心力衰竭和肺炎再入院率。能源价格数据包括各州平均馏分燃料、电力和天然气价格，以及美国平均煤炭价格。所有价格数据均使用消费者价格指数乘数换算为2014年美元。

结果

煤炭价格变化与30天心力衰竭死亡率的短期（=0.029）和长期（=0.017）变化之间存在显著正相关。煤炭价格变化与30天肺炎死亡率的短期（<0.001）和长期（=0.002）变化之间也存在类似的显著正相关。煤炭价格变化还与30天心肌梗死再入院率的长期变化呈正相关（<0.001）。煤炭价格（=0.20）、天然气价格（=0.040）和电力价格（=0.040）的变化与30天心力衰竭再入院率的长期变化呈正相关。