Association of outdoor air pollution with the medical expense of ischemic stroke: The case study of an industrial city in western China

Zeng, Siyu; Luo, Li; Fang, Chen; Li, Yue; Chen, Mei; He, Xiaozhou

doi:10.1002/hpm.3115

Cited by 3 publications

(2 citation statements)

References 40 publications

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“…Additionally, all of these factors further weaken the equitable use of medical resources. 11 However, the government must also adjust the basic medical reimbursement project to reduce medical costs and improve the fairness of medical reimbursement while ensuring the quality of medical services. Social health insurance is not sufficient, and therefore the payment system must be improved to coincide with the increase in medical costs.…”

Section: Discussionmentioning

confidence: 99%

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Big Data-Enabled Analysis of Factors Affecting Medical Expenditure in the Cerebral Infarction of a Developing City in Western China

Zeng,

Zhang,

Guo

et al. 2023

RMHP

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Purpose Cerebral infarction (CI) has been one of the leading causes of death in China since 2017, and controlling the medical expenses of this disease is an urgent issue for the Chinese government. This study aims to explore the important factors that affect the hospitalization expenses of CI patients and to provide a scientific basis for establishing a reasonable reimbursement mechanism and hospitalization expense standard for CI patients. Methods Data from 109,314 inpatients from the Healthcare Security Administration of Chengdu in western China from January 2016 to December 2018 were utilized. Descriptive statistical analysis was used for variable characteristic analysis. The Mann–Whitney test and Kruskal–Wallis test were used for single-factor analysis, and multiple linear stepwise regression was used for single-factor analysis and multiple-factor analysis. Results This study found that the average direct economic burden of CI in Chengdu was approximately 10,569 Chinese yuan (CNY), about 1450 US dollars, the average length of stay (LOS) was 14.47 days, the indirect economic burden was approximately 2817 CNY, and the total economic burden was 13,386 CNY for a CI inpatient. Gender, insurance type, grade of medical institution, the level of payment type, age, LOS, and complications and comorbidities (CCs) are the most important factors affecting CI medical costs. Conclusion Citizens should improve their lifestyle habits to reduce disease risk to avoid the associated medical and economic burdens. Hospitals should improve their medical technology to decrease the LOS and reduce direct medical costs. The government should actively promote the hierarchical diagnosis and treatment policy to reduce the waste of medical resources caused by low-acuity patients going to high-level hospitals for treatment. The National Healthcare Security Administration should optimize the medical insurance payment method and establish a corresponding mechanism to reduce the occurrence of excessive medical treatments such as overuse.

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Section: Discussionmentioning

confidence: 99%

“… 9 , 10 About 80% of all strokes are CI. 11 In this study, a total of 297,757 patients with CI were hospitalized from 2011 to 2018. Among them were 149,376 males and 148,381 females, accounting for 50.16% and 49.84%, respectively.…”

Section: Introductionmentioning

confidence: 99%

Big Data-Enabled Analysis of Factors Affecting Medical Expenditure in the Cerebral Infarction of a Developing City in Western China

Zeng,

Zhang,

Guo

et al. 2023

RMHP

Self Cite

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The association between short-term ambient sulfur dioxide exposure and hospitalization costs of ischemic stroke: a hospital-based study in Chongqing, China

Tang

Zhou

Yang

et al. 2022

Environ Sci Pollut Res

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Short-term exposure to nitrogen dioxide and emergency department visits for cause-stroke: a time-series study in Shanghai, China, 2013–2022

Zhou,

Jin,

Zhang

2024

Environ Health Prev Med

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Background The association between air pollution and an increased risk of cardiovascular diseases, including stroke, is well-established. However, it remains unclear how reductions in pollutant levels—resulting from clean air policies and the COVID-19 lockdown—affect this relationship. Methods A time-series study was conducted using data from Shanghai, China, spanning from 2013 to 2022, divided into two periods (2013–2019 and 2020–2022). Daily air pollution data were obtained from China’s air quality platform, while stroke emergency department (ED) visits were sourced from Renhe Hospital. We employed quasi-Poisson regression to analyze the relationship between daily pollutant levels and stroke ED visits, with stratified analyses by sex, age, season, and period. The study identified significant reductions in six pollutants (PM 2.5 , PM 10–2.5 , PM 10 , SO 2 , NO 2 , CO) during the 2020–2022 period compared to 2013–2019. Results Significant reductions in six air pollutants (NO 2 , PM 2.5 , PM 10–2.5 , PM 10 , SO 2 , CO) were observed during 2020–2022 compared to 2013–2019. Higher daily NO 2 levels were associated with an increased risk of stroke and its subtypes throughout the study, with a stronger correlation observed in the 2020–2022 period ( P < 0.001). Subgroup analyses indicated that females and individuals aged 65–74 experienced the highest risks. The elevated stroke risk was particularly pronounced in the summer during 2020–2022. A two-factor model demonstrated that combined exposure to NO 2 and other pollutants increased stroke risk. Conclusions This study heightened that reduced NO 2 levels generally mitigate the adverse effects of short-term exposure to air pollutants on stroke risk, although the benefits vary among subgroups. The persistent stroke risk despite lower pollutant levels underscores the complex factors influencing stroke risk, highlighting the need for comprehensive intervention strategies. Supplementary information The online version contains supplementary material available at https://doi.org/10.1265/ehpm.24-00304 .

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Association of outdoor air pollution with the medical expense of ischemic stroke: The case study of an industrial city in western China

Cited by 3 publications

References 40 publications

Big Data-Enabled Analysis of Factors Affecting Medical Expenditure in the Cerebral Infarction of a Developing City in Western China

Big Data-Enabled Analysis of Factors Affecting Medical Expenditure in the Cerebral Infarction of a Developing City in Western China

The association between short-term ambient sulfur dioxide exposure and hospitalization costs of ischemic stroke: a hospital-based study in Chongqing, China

Short-term exposure to nitrogen dioxide and emergency department visits for cause-stroke: a time-series study in Shanghai, China, 2013–2022

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