Economic Burden of Hospitalizations for Heat-Related Illnesses in the United States, 2001-2010.
Understanding how heat waves affect morbidity and mortality, as well as the associated economic costs, is essential for characterizing the human health impacts of extreme heat under a changing climate. Only a handful of studies have examined healthcare costs associated with exposures to high temperatures. This research explores costs associated with hospitalizations for heat-related illness (HRI) in the United States using the 2001 to 2010 Nationwide Inpatient Sample (NIS). Descriptive statistics of patient data for HRI hospitalizations were examined and costs of hospitalizations were reported using the all-payer inpatient cost-to-charge ratio. Costs were examined using a log-gamma model with patient and hospital characteristics included as fixed effects. Adjusted mean costs were then compared across racial groups. The mean costs of HRI hospitalizations were higher among racial/ethnic minorities compared to Whites, who accounted for almost 65% of all HRI hospitalizations. Observed differences in costs based on income, insurance, and gender were also significant. These results suggest that these populations are suffering disproportionately from health inequity, thus, they could shoulder greater disease and financial burdens due to climate change. These findings may have important implications in understanding the economic impact public health planning and interventions will have on preventing hospitalizations related to extreme heat.
ASPPH/EPA Environmental Health Fellowship Program at the United States Environmental Protection Agency, Office of Research and Development, National Center for Environmental Assessment, Washington, DC 20001, USA. schmeltz.michael@epa.gov.
Michael T
MT
Schmeltz
National Center for Disaster Preparedness, Earth Institute, Columbia University, New York, NY 10027, USA. epp2109@cumc.columbia.edu.
Elisaveta P
EP
Petkova
United States Environmental Protection Agency, Office of Research and Development, National Center for Environmental Assessment, Washington, DC 20460, USA. gamble.janet@epa.gov.
Janet L
JL
Gamble
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D057231:Climate Change; D005006:Ethnicity / Q000706:statistics & numerical data; D055874:Extreme Heat / Q000009:adverse effects*; D005260:Female; D017048:Health Care Costs / Q000639:trends*; D018882:Heat Stress Disorders / Q000191:economics*; D006760:Hospitalization / Q000191:economics*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007297:Inpatients / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D014481:United States; D044465:White People / Q000706:statistics & numerical data; D055815:Young Adult
climate change; economic cost; health equity; heat-related illness; hospitalizations; racial disparities