Abstract
Although hospital length of stay (LOS) has been identified as a proxy measure of healthcare expenditures in the United States, there are limited studies investigating the potentially important association between outdoor air pollution and LOS for pediatric asthma. This study aims to examine the effect of ambient air pollution on LOS among children with asthma in South Texas. It included retrospective data on 711 children aged 5–18 years old admitted for asthma to a pediatric tertiary care hospital in South Texas between 2010 and 2014. Air pollution data including particulate matter (PM2.5) and ozone were collected from the U.S. Centers for Disease Control and Prevention. The multivariate binomial logistic regression analyses were performed to determine the association between each air pollutant and LOS, controlling for confounders. The regression models showed the increased ozone level was significantly associated with prolonged LOS in the single- and two-pollutant models (p < 0.05). Furthermore, in the age-stratified models, PM2.5 was positively associated with LOS among children aged 5–11 years old (p < 0.05). In conclusion, this study revealed a concerning association between ambient air pollution and LOS for pediatric asthma in South Texas.
Highlights
Hospital length of stay (LOS) is a significant determinant of overall healthcare expenses, and often viewed as a proxy for cost of care
We examined the association between short-term exposure to outdoor air pollution and hospital LOS among children with asthma in South Texas
We found that increased ozone concentration prior to hospital admission was significantly associated with prolonged hospital LOS
Summary
Hospital length of stay (LOS) is a significant determinant of overall healthcare expenses, and often viewed as a proxy for cost of care. As such, increased LOS causes a substantial economic burden on patients/families and health insurance, including the government [1]. Despite improvements in medical care and medication, the median hospital LOS for pediatric asthma has not changed significantly for the past decades [2]. Hospital LOS is frequently regarded as an important measurement of healthcare efficiency and resource utilization and greatly affects healthcare planning, hospital capacity, and policy [3,4]. Identifying factors that affect hospital LOS is crucial in order to improve health outcomes and effective use of healthcare resources as well as reduce healthcare costs [4].
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