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日本12个城市中环境细颗粒物(PM)与全因住院率和总费用的短期关联

Short-Term Associations of Ambient Fine Particulate Matter (PM) with All-Cause Hospital Admissions and Total Charges in 12 Japanese Cities.

作者信息

Hasegawa Kohei, Toubou Hirokazu, Tsukahara Teruomi, Nomiyama Tetsuo

机构信息

Department of Preventive Medicine and Public Health, School of Medicine, Shinshu University, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan.

Department of Occupational Medicine, School of Medicine, Shinshu University, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan.

出版信息

Int J Environ Res Public Health. 2021 Apr 13;18(8):4116. doi: 10.3390/ijerph18084116.

Abstract

The short-term association between ambient particulate matter ≤2.5 microns in diameter (PM) and hospital admissions is not fully understood. Studies of this association with hospital admission costs are also scarce, especially in entire hospitalized populations. We examined the association between ambient PM and all-cause hospital admissions, the corresponding total charges, and the total charges per patient by analyzing the hospital admission data of 2 years from 628 hospitals in 12 cities in Japan. We used generalized additive models with quasi-Poisson regression for hospital admissions and generalized additive models with log-linear regression for total charges and total charges per patient. We first estimated city-specific results and the combined results by random-effect models. A total of 2,017,750 hospital admissions were identified. A 10 µg/m increase in the 2 day moving average was associated with a 0.56% (95% CI: 0.14-0.99%) increase in all-cause hospital admissions and a 1.17% (95% CI: 0.44-1.90%) increase in total charges, and a 10 µg/m increase in the prior 2 days was associated with a 0.75% (95% CI: 0.34-1.16%) increase in total charges per patient. Short-term exposure to ambient PM was associated with increased all-cause hospital admissions, total charges, and total charges per patient.

摘要

环境中直径≤2.5微米的颗粒物(PM)与住院之间的短期关联尚未完全明确。关于这种关联与住院费用的研究也很稀少,尤其是在全体住院人群中。我们通过分析日本12个城市628家医院两年的住院数据,研究了环境PM与全因住院、相应的总费用以及每位患者的总费用之间的关联。我们对住院情况使用了带有拟泊松回归的广义相加模型,对总费用和每位患者的总费用使用了带有对数线性回归的广义相加模型。我们首先通过随机效应模型估计了特定城市的结果和综合结果。共识别出2,017,750例住院病例。两天移动平均值每增加10微克/立方米,全因住院病例增加0.56%(95%置信区间:0.14 - 0.99%),总费用增加1.17%(95%置信区间:0.44 - 1.90%),前两天每增加10微克/立方米,每位患者的总费用增加0.75%(95%置信区间:0.34 - 1.16%)。短期暴露于环境PM与全因住院病例、总费用以及每位患者的总费用增加有关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f12a/8070111/2dccf7128f2d/ijerph-18-04116-g001.jpg

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