上海市大气污染对三级医院日医保急诊人次的影响

Influence of Shanghai air pollution on emergency person-times with medical insurance payment in third grade hospitals

目的研究上海市大气污染水平与三级医院日医保急诊人次的关系。方法选用广义相加模型（generalized additive model，GAM）分析时间序列资料，并在模型中加入自回归模型AR（P）处理时间序列资料自相关的问题，在控制了与时间有关的中长期趋势、星期效应、节假日效应、非典事件、气象因素等混杂因素的基础上，分析了上海市2002--2004年间3种大气污染物PM10、SO2和NO2日均浓度变化与三级医院日医保急诊人次的关系。结果大气污染物PM10、SO2和NO2日均浓度每增加10μg／m^3，上海市三级医院医保急诊就诊的相对危险度分别为1．0017（95％CI1．0001～1．0034），1．0066（95％CI1．0020～1．0111）和1．0052（95％CI1．0011-1．0094）。结论在上海市目前的大气污染水平下，所研究的3种污染物浓度水平对三级医院医保急诊人次有影响。

Objective To observe the relationship between air pollution and emergency room visits with medicare of third class hospitals in Shanghai. Methods We used generalized additive model（GAM） to analyze time series, and used AR （P） to deal with auto-correlation of time series. We estimated the relationship between air pollution and emergency room visits after controlling for medium-term and long-term trends, day of the week, vocation, typical pneumonia and meteorologic variables. Results Each increase of 10μg/m^3 in PM10 ,SO2 and NO2 was found to correspond, respectively, to a 1. 0017 （95% CI 1. 000 1 -1.0034） , 1.0066 （95%CI 1.002 0 -1.011 1） and 1.005 2 （95% CI 1.001 1 -1.009 4） relative risk emergency room visits with medicare of third class hospitals in Shanghai. Conclusion Our findings indicate that the current air pollution has an acute effect on emergency room visits with medcare of third class hospitals in Shanghai.