Pamela A. MacLean
RedwoodAge.com

Want to reduce the cost of hospital care in America?  A new study suggest clearing the air around the issue. Literally.

Just in California, nearly 30,000 emergency room visits and hospital admissions stemmed from the state's failure to meet clean air standards, thus exposing the public to excessive levels of ozone and particulate pollution, according to the three-year RAND Corp. study.

"Failing to meet federal clean air standards cost health care purchasers more than $193 million for hospital care alone" for treating asthma and pneumonia problems trigged by elevated pollution levels, the report said. About $75 million of that cost stemmed from elders over 65, although they represented just one in five hospital admissions.

The hospital costs hit both public and private health care providers, but taxpayers picked up much of the tab.  An estimated two-thirds of the expenses fell to Medicare, the federal insurance program for people over 62, and to Medi-Cal, state health care for low-income and disabled residents.

"These costs may not be the largest problem caused by dirty air, but our study provides more evidence about the impact that air pollution has on the state's economy," said John Romley, lead author of the study and an economist at RAND, a nonprofit research group.

"California's failure to meet air pollution standards causes a large amount of expensive hospital care," he said.

Comparing Data
The researchers used records from air pollution agencies and hospitals to estimate how failing to meet federal and state standards for particulate matter and ozone would affect private and public insurer spending for hospital admissions on respiratory and cardiovascular causes, as well as emergency room visits.

The most common hospital visits triggered by high air pollution levels were among children under 17 suffering asthma attacks and heading for the emergency room, accounting for more than 12,000 visits in the three-year study period.. 

But the most costly conditions reported by researchers were hospital admissions for acute bronchitis, pneumonia and chronic obstructive pulmonary disease, more common conditions of older Americans.  These accounted for nearly one-third of the $193 million in health spending documented in the study.

The frequent trigger of health events were high levels of fine particular pollution, the tiny pieces of soot that can lodge in the lungs.  These were concentrated in the San Joaquin Valley and the four-county South Coast Air Basin in Southern California, according to the report.

Although pneumonia and cardiovascular admissions for people over 65 accounted for 6,000 of the nearly 30,000 hospital admissions, they represented more than $75 million of the $193 million in costs.

Of the total costs, Medicare, which primarily covers the elderly, spent $103.6 million on air pollution-related hospital care during 2005-2007.