Document Detail


The effects of outdoor air pollutants on the costs of pediatric asthma hospitalizations in the United States, 1999 to 2007.
MedLine Citation:
PMID:  21430578     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Acute exposure to outdoor air pollutants has been associated with increased pediatric asthma morbidity. However, the impact of subchronic exposures is largely unknown.
OBJECTIVE: To examine the association between subchronic exposure to 6 outdoor air pollutants (PM2.5, PM10, ozone, nitrogen oxides, sulfur oxides, carbon monoxide) and pediatric asthma hospitalization length of stay, charges, and costs.
METHODS: We linked pediatric asthma hospitalization discharge data from a nationally representative dataset, the 1999-2007 Nationwide Inpatient Sample, with outdoor air pollution data from the Environmental Protection Agency. Hospitals with no air quality data within 10 miles were excluded. Our predictor was the average concentration of 6 pollutants near the hospital during the month of admission. We conducted bivariate analyses using Spearman correlations and multivariable analyses using Poisson regression for length of stay and linear regression for log-transformed charges and costs, controlling for patient demographics, hospital characteristics, and month of admission.
RESULTS: In unadjusted analyses, all 6 pollutants had minimal correlation with the 3 outcomes (ρ<0.1, P<0.001). In multivariable analyses, a 1-unit (μg/m) increase in monthly PM2.5 led to a $123 increase in charges (95% confidence interval $40-249) and a $47 increase in costs (95% confidence interval $15-93). No other pollutants were significant predictors of charges or costs or length of stay.
CONCLUSION: Subchronic PM2.5 exposure is associated with increased costs for pediatric asthma hospitalizations. Policy changes to reduce outdoor subchronic pollutant exposure may lead to improved asthma outcomes and substantial savings in healthcare spending.
Authors:
Angkana Roy; Perry Sheffield; Kendrew Wong; Leonardo Trasande
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Medical care     Volume:  49     ISSN:  1537-1948     ISO Abbreviation:  Med Care     Publication Date:  2011 Sep 
Date Detail:
Created Date:  2011-08-24     Completed Date:  2011-10-24     Revised Date:  2013-07-19    
Medline Journal Info:
Nlm Unique ID:  0230027     Medline TA:  Med Care     Country:  United States    
Other Details:
Languages:  eng     Pagination:  810-7     Citation Subset:  IM    
Affiliation:
Departments of Preventive Medicine and Pediatrics, Mount Sinai School of Medicine, One Gustave L. Levy Place, New York, NY 10029, USA. aroy@eriefamilyhealth.org.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Air Pollutants / adverse effects*,  analysis
Asthma / economics*,  epidemiology*,  etiology
Case-Control Studies
Child
Child, Preschool
Cross-Sectional Studies
Female
Health Care Costs*
Hospitalization / economics*
Humans
Male
Multivariate Analysis
Poisson Distribution
Regression Analysis
Grant Support
ID/Acronym/Agency:
5T32 HD049311/HD/NICHD NIH HHS; T32 HD049311/HD/NICHD NIH HHS
Chemical
Reg. No./Substance:
0/Air Pollutants
Comments/Corrections

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