Cold temperature-related attributable risk for emergency circulatory hospitalizations, length of stay, and healthcare costs in Hong Kong
Background: The association of ambient temperature with the length of hospital stays and healthcare costs has not been well-explored. We aimed to examine the association of temperature with emergency hospital admission (EHA) count and length of stay (LOS) for total and cause-specific circulatory dis...
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Elsevier
2025-02-01
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| Series: | Ecotoxicology and Environmental Safety |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S0147651325001630 |
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| author | Eliza Lai-Yi Wong Hong Qiu |
| author_facet | Eliza Lai-Yi Wong Hong Qiu |
| author_sort | Eliza Lai-Yi Wong |
| collection | DOAJ |
| description | Background: The association of ambient temperature with the length of hospital stays and healthcare costs has not been well-explored. We aimed to examine the association of temperature with emergency hospital admission (EHA) count and length of stay (LOS) for total and cause-specific circulatory diseases and evaluate the temperature-related attributable risk and healthcare costs. Methods: This ecologic time series analysis linked the daily circulatory EHA count and LOS from the Hong Kong Hospital Authority with the environmental exposures from the fixed monitoring stations from 2004 to 2019. The generalized linear quasi-Poisson model integrated with a distributed lag nonlinear model was applied to examine ambient temperatures' relative and attributable risks on EHA counts and LOS while adjusting the time-varying confounders. Temperature-related healthcare costs were evaluated based on the estimated attributable number (AN) and charges per attendance or bed day. Results: Among 1276,632 EHAs and 7621,232 bed days of LOS, significant associations of cold temperatures with both EHA counts and LOS for total and cause-specific circulatory diseases were found. The temperature-related attributable fraction (AF) was estimated as 7.98 % (95 % CI: 5.24–10.58 %) for EHA count and 13.09 % (6.80–18.28 %) for LOS for total circulatory diseases. The cold temperature defined as the lower quartile of the ambient temperature range explained more than half of the temperature-related attributable risk and healthcare costs. Conclusion: Cold weather can lead to adverse health outcomes, with considerable pressure on the healthcare system. Longer LOS-associated higher healthcare costs in colder weather may have implications for developing targeted preventions and hospital service planning. |
| format | Article |
| id | doaj-art-e87c8f0eb82742e0b70cc32beab52caf |
| institution | Kabale University |
| issn | 0147-6513 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Elsevier |
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| series | Ecotoxicology and Environmental Safety |
| spelling | doaj-art-e87c8f0eb82742e0b70cc32beab52caf2025-02-05T04:31:03ZengElsevierEcotoxicology and Environmental Safety0147-65132025-02-01291117827Cold temperature-related attributable risk for emergency circulatory hospitalizations, length of stay, and healthcare costs in Hong KongEliza Lai-Yi Wong0Hong Qiu1Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong; JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong; Corresponding authors at: Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong.Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong; JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong; Corresponding authors at: Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong.Background: The association of ambient temperature with the length of hospital stays and healthcare costs has not been well-explored. We aimed to examine the association of temperature with emergency hospital admission (EHA) count and length of stay (LOS) for total and cause-specific circulatory diseases and evaluate the temperature-related attributable risk and healthcare costs. Methods: This ecologic time series analysis linked the daily circulatory EHA count and LOS from the Hong Kong Hospital Authority with the environmental exposures from the fixed monitoring stations from 2004 to 2019. The generalized linear quasi-Poisson model integrated with a distributed lag nonlinear model was applied to examine ambient temperatures' relative and attributable risks on EHA counts and LOS while adjusting the time-varying confounders. Temperature-related healthcare costs were evaluated based on the estimated attributable number (AN) and charges per attendance or bed day. Results: Among 1276,632 EHAs and 7621,232 bed days of LOS, significant associations of cold temperatures with both EHA counts and LOS for total and cause-specific circulatory diseases were found. The temperature-related attributable fraction (AF) was estimated as 7.98 % (95 % CI: 5.24–10.58 %) for EHA count and 13.09 % (6.80–18.28 %) for LOS for total circulatory diseases. The cold temperature defined as the lower quartile of the ambient temperature range explained more than half of the temperature-related attributable risk and healthcare costs. Conclusion: Cold weather can lead to adverse health outcomes, with considerable pressure on the healthcare system. Longer LOS-associated higher healthcare costs in colder weather may have implications for developing targeted preventions and hospital service planning.http://www.sciencedirect.com/science/article/pii/S0147651325001630Ambient temperatureAttributable riskCause-specific circulatory diseasesEmergency hospital admissionHealthcare costLength of stay |
| spellingShingle | Eliza Lai-Yi Wong Hong Qiu Cold temperature-related attributable risk for emergency circulatory hospitalizations, length of stay, and healthcare costs in Hong Kong Ecotoxicology and Environmental Safety Ambient temperature Attributable risk Cause-specific circulatory diseases Emergency hospital admission Healthcare cost Length of stay |
| title | Cold temperature-related attributable risk for emergency circulatory hospitalizations, length of stay, and healthcare costs in Hong Kong |
| title_full | Cold temperature-related attributable risk for emergency circulatory hospitalizations, length of stay, and healthcare costs in Hong Kong |
| title_fullStr | Cold temperature-related attributable risk for emergency circulatory hospitalizations, length of stay, and healthcare costs in Hong Kong |
| title_full_unstemmed | Cold temperature-related attributable risk for emergency circulatory hospitalizations, length of stay, and healthcare costs in Hong Kong |
| title_short | Cold temperature-related attributable risk for emergency circulatory hospitalizations, length of stay, and healthcare costs in Hong Kong |
| title_sort | cold temperature related attributable risk for emergency circulatory hospitalizations length of stay and healthcare costs in hong kong |
| topic | Ambient temperature Attributable risk Cause-specific circulatory diseases Emergency hospital admission Healthcare cost Length of stay |
| url | http://www.sciencedirect.com/science/article/pii/S0147651325001630 |
| work_keys_str_mv | AT elizalaiyiwong coldtemperaturerelatedattributableriskforemergencycirculatoryhospitalizationslengthofstayandhealthcarecostsinhongkong AT hongqiu coldtemperaturerelatedattributableriskforemergencycirculatoryhospitalizationslengthofstayandhealthcarecostsinhongkong |