2026-10-12T01:54:44Z https://api.figshare.com/v2/oai

oai:figshare.com:article/33718891 2026-09-14T05:38:16Z category_427 portal_316 item_type_3 month_year_09_2026

Supplementary file 1_Short-term lagged exposure to ambient air pollutants and hospitalization costs among AMI patients: health-economic evidence from a low-pollution Chinese city with DRG/DIP standardized medical payment.docx Junming Lin (6842345) Faqiu Chen (24868294) Xueqing Zeng (24868297) Dongwen Liu (22354386) Public Health and Health Services not elsewhere classified acute myocardial infarction ambient criteria pollutants DRG/DIP payment reform health economic burden hospitalization cost lag effect Background<p>Ambient air pollution poses substantial cardiovascular health and economic burdens worldwide, yet existing evidence largely focuses on high-pollution regions and clinical endpoints such as incidence or mortality. Few studies have quantified air pollution-attributable hospitalization costs for acute myocardial infarction (AMI), especially under low air quality conditions. Combined with China's Diagnosis-Related Groups (DRG) / Diagnosis-Intervention Packet (DIP) case-mix medical payment reform, hospitalization expenses can serve as a reliable proxy reflecting AMI disease severity and healthcare resource consumption, providing a unique health-economic perspective for environmental public health policy-making.</p>Methods<p>A single-center retrospective cohort study was conducted including 3,650 percutaneous coronary intervention (PCI)-treated AMI patients admitted to Jiangmen Central Hospital (2018–2024), a subtropical city with year-round air pollutant concentrations meeting China Grade II standards. Lag-stratified Gamma generalized linear models with log link were applied to evaluate associations between pre-admission 0–6 day exposure to six criteria pollutants (PM_2.5, PM₁₀, SO₂, NO₂, CO, O₃) and AMI hospitalization costs. All single-pollutant models were fully adjusted for demographics, comorbidities, seasons, weekdays, and non-linear meteorological confounders. Benjamini–Hochberg false discovery rate (FDR) correction was used to control multiple testing bias. A sensitivity analysis restricted to 1,590 never-smoking patients was performed.</p>Results<p>Short-term exposure to SO₂, PM_2.5, PM₁₀, NO₂, and CO was significantly associated with elevated AMI medical expenditures, while O₃ showed no overall significant correlation. Per natural log-unit elevation, SO₂ generated the largest cost increase (average 2.40%, ~729 CNY) with consistent adverse effects across all lag days; particulate pollutants PM_2.5 and PM₁₀ exhibited delayed peak risks at lag 4–5 days. In never-smokers, O₃ triggered significant cost rises at lag 3 and lag 5, indicating non-smokers as vulnerable subgroups susceptible to ozone toxicity. Multicollinearity diagnostics validated the rationality of single-pollutant modeling.</p>Conclusions<p>Even low-level ambient air pollution compliant with current national standards increases the economic burden of AMI treatment, with SO₂ showing the strongest association. Smoking modifies cardiovascular cost-related effects of ozone. This population-level health-economic evidence supports stricter air quality regulations, and the integration of ambient exposure indicators into AMI risk stratification and public health resource allocation under the DRG/DIP payment system.</p> 2026-09-14T05:38:16Z Dataset Dataset 10.3389/fpubh.2026.1939605.s001 https://figshare.com/articles/dataset/Supplementary_file_1_Short-term_lagged_exposure_to_ambient_air_pollutants_and_hospitalization_costs_among_AMI_patients_health-economic_evidence_from_a_low-pollution_Chinese_city_with_DRG_DIP_standardized_medical_payment_docx/33718891 CC BY 4.0