Abstract
Air pollution contributes to the development of numerous adverse human health outcomes. The Environmental Protection Agency's Environmental Benefits Mapping and Analysis Program-Community Edition (BenMAP-CE) tool is widely used in estimating the health care costs of air pollution and in the development of federal and state regulations and policy. Its default features consider only the costs of hospital and emergency department admissions. A more complete accounting of the chain of costs would include ambulatory and other care. In this article we use employer health insurance claims data to infer additional costs that accompany hospitalizations but are not included in BenMAP-CE. Including additional categories increases BenMAP-CE health care cost estimates by approximately 40percent for respiratory and cardiovascular patients. That is, for each dollar of health care costs captured by BenMAP-CE, a more complete accounting would include an additional 40 cents. These results suggest that because such air pollution costs are underestimated, the health care benefits associated with reducing air pollution may be much larger than previously estimated.
Highlights
Short- and long-term air pollution exposure exacerbates and contributes to the development of numerous adverse health outcomes.[1,2,3,4,5,6,7,8,9] For example, air pollutants such as particulate matter and ground-level ozone can exacerbate preexisting conditions and contribute to increased incidence of disease, respiratory and cardiovascular conditions.[1]
The Environmental Benefits Mapping and Analysis Program–Community Edition (BenMAP-CE) is a tool historically used by the Environmental Protection Agency (EPA) to estimate the economic impact of a range of clinical outcomes due to air pollution, including the cost of a subset of impacts
These results suggest that policy analyses using the BenMAP-CE model may substantially underestimate the health care benefits of reductions in air pollution
Summary
Short- and long-term air pollution exposure exacerbates and contributes to the development of numerous adverse health outcomes.[1,2,3,4,5,6,7,8,9] For example, air pollutants such as particulate matter and ground-level ozone can exacerbate preexisting conditions and contribute to increased incidence of disease, respiratory (such as chronic bronchitis and asthma) and cardiovascular conditions.[1]. The Environmental Benefits Mapping and Analysis Program–Community Edition (BenMAP-CE) is a tool historically used by the Environmental Protection Agency (EPA) to estimate the economic impact of a range of clinical outcomes due to air pollution, including the cost of a subset of impacts (hospital admissions and emergency department [ED] visits). Both morbidity and mortality outcomes are considered.[11,12,13] BenMAP-CE includes concentration-response parameters and unit economic values to quantify the air pollution–attributable cases of premature death. Carley is a senior analyst in the Health Care and the Energy and Environment practices at Analysis Group, Inc
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