Temperature variability associated with respiratory disease hospitalisations, hospital stays and hospital expenses in a warm, temperate, sub-humid, monsoon climate

• Published in: Public health (London) 2023-12, Vol.225, p.206-217
• Main Authors: Zhai, Chunxia, Bai, Liangliang, Xu, Ying, Liu, Yuqi, Sun, Hongyu, Gong, XingYu, Yu, Guanghui, Zong, Qiqun, Hu, Wanqin, Wang, Fang, Cheng, Jian, Zou, Yanfeng
• Format: Article
• Language: English
• Subjects: Hospital expenses; Hospital stays; Hospitalisation; Respiratory disease; Temperature variability
• ISSN: 0033-3506; 1476-5616
• DOI: 10.1016/j.puhe.2023.10.013

The change of climate has led to an increasing trend of hospitalised patients in recent years. This study aimed to analyse the temperature variability (TV) associated with respiratory disease (RD) hospitalisations, hospital stays and hospital expenses. The generalised linear model combined with distributed lag nonlinear model was used to investigate the association between TV and RD hospitalisations. TV was determined by measuring the standard deviation of maximum and minimum temperatures for the selected day and the previous 7 days. RD hospitalisation data were obtained from three major tertiary hospitals in Huaibei City; namely, the Huaibei People's Hospital, the Huaibei Hospital Of Traditional Chinese Medicine and the Huaibei Maternal and Child Health Care Hospital. First, using a time-series decomposition model, the seasonality and long-term trend of hospitalisations, hospital stays and hospital expenses for RD were explored in this warm, temperate, sub-humid, monsoon climate. Second, robust models were used to analyse the association between TV and RD hospitalisations, hospital stays and hospital expenses. In addition, this study stratified results by sex, age and season. Third, using the attributable fraction (AF) and attributable number (AN), hospitalisations, hospital stays and hospital expenses for RD attributed to TV were quantified. Overall, 0.013% of hospitalisations were attributed to TV0-1 (i.e. TV between selected day and previous day), corresponding to 220 cases, 1603 days of hospital stays and 1,308,000 RMB of hospital expenses. Females were more susceptible to TV than males, and the risk increased with longer exposure (the highest risk was seen at TV0-7 [i.e. TV between selected day and the previous 7 days] exposure). Higher AF and AN were observed at ages 0–5 years and ≥65 years. In addition, it was also found that TV was more strongly linked to RD in the cool season. The hot season was positively associated with hospital stays and hospital expenses at TV0-3 to TV0-7 exposure. Exposure to TV increased the risk of hospitalisation, longer hospital stays and higher hospital expenses for RD. The findings suggested that more attention should be paid to unstable weather conditions in the future to protect the health of vulnerable populations. [Display omitted]