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Improved Air Quality from China's Clean Air Actions Alleviates Health Expenditure Inequality
18 Pages Posted: 20 Sep 2022
More...Abstract
Background: The clean air actions aimed at improving air quality in China have brought about significant health benefits, thereby generating substantial savings in air-pollution-related healthcare spending. Few studies have investigated the uneven regional air quality improvements and economic developments that may alter existing inequality in health expenditures in the context of scarce healthcare resources.
Methods: Daily air pollutants data were derived from the China National Urban Air Quality Real-time Publishing Platform and daily disease-related health expenditures of 98 Chinese cities over the year 2015-2017 were obtained from the urban employee-based basic medical insurance scheme database (UEBMI). We developed an econometric model that resolves individual characteristics at the city level to examine the disparity of public health expenditures in air quality improvements across regions differing in economic development and healthcare coverages and projected a range of future health expenditure savings under different air quality targets.
Findings: Based on the estimation of four air-pollution-related diseases (COPD, LRI, IHD, and Stroke), a decline of 8.26% in average hospitalization days and 10.21% in hospitalization expenses was achieved, leading to a reduction of 8.09% in total health expenditures as the implementation of clean air actions. Improved air quality has declined health expenditure inequality in low-middle cities and cities with imbalanced healthcare coverages. The total expenses for the four diseases declined significantly in the low (-11.31%) and medium (-7.34%) per capita GDP groups, as well as a remarkable decline in the fewer medical resources. Health savings in some future scenarios are significant, showing substantial health expenditure savings under different air quality targets, but the population aging trend will offset the reduction effect. Our findings thus highlight the importance of strengthening air pollution control policies and considering the equality of alleviating regional public health costs.
Funding Information: The study was supported by the National Natural Science Foundation of China (72134006).
Declaration of Interests: The authors declare no competing interests.
Keywords: clean air action, hospital admissions, health expenditure, inequality, chinese cities
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