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To Assess Effect of Temperature on Cardiovascular Diseases Out-patient Visits in Shanghai Residents with Medical Insurance

Author: YuYongFu
Tutor: ZhaoNaiQing
School: Fudan University
Course: Epidemiology and Biostatistics,
Keywords: Air temperature Cardiovascular disease Outpatient visits Generalized Additive Models Medicare
CLC: R195.1
Type: Master's thesis
Year: 2011
Downloads: 75
Quote: 0
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Abstract


Objective: To study the health effects of the temperature of the Shanghai Medicare crowd cardiovascular medicine outpatient visits. Implications for research: the impact of climate change on human health has become a global concern. Frequent extreme weather events in recent years, researchers are increasingly concerned about climate-related health effects. As far as we know, the temperature changes in the study of the health effects, the vast majority of researchers selected indicators of mortality or hospitalization rates as the health effects have not been identified as indicators of the health effects literature outpatient visits. Many hospitals in Shanghai, especially the top three hospital beds are often in a saturated, hospitalization situation does not reflect the true effect: mortality reflects the serious condition of the health status of the population, are not suitable to reflect the effect of temperature on the health of the general population. The hospital outpatient Basic can be satisfied with the health needs of the residents, the daily clinic attendances better able to reflect the effect of temperature on the health of the general population can effectively evaluate the effect of climate change on disease onset. Rising morbidity and mortality due to cardiovascular disease, cardiovascular disease mortality first place, higher than that of tumors and other diseases, is becoming a huge threat to our national health. Understanding of temperature changes on the the cardiovascular outpatient attendances health effects, will help control the occurrence and development of cardiovascular disease, has a very important public health significance. Research content and methods: generalized additive Poisson regression model, the use of natural cubic spline function to control the time and long-term trends, barometric pressure, relative humidity, wind speed, rainfall, atmospheric pollutants of PM10, S02 and NO2 impact dummy variable described in week effect, holiday effect, the confounding effects of health insurance policies, analysis of the relationship between temperature change between 2005 and 2010 and the Shanghai Medicare crowd cardiovascular medicine outpatient visits. The observed data for time series data, there is autocorrelation problem, based on the autocorrelation function of the size of the model into the autocorrelation AR (P) control autocorrelation. The main results and conclusions: The a sliding average temperature of day (day and two days before the value) as a temperature indicator, GAM model autocorrelation function is greater than 0.1, included in the model autocorrelation AR (P) control autocorrelation , to use GAM AR (P) in the analysis of temperature and cardiovascular medicine outpatient visits. In the range of temperatures less than 9 ° C and the air temperature is greater than 26 ℃, as the temperature rises, the cardiovascular disease with the temperature changes in the relative risk curve showed a rapid downward trend, indicating that as the temperature rises, the relative risk of cardiovascular disease significantly reduced.

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CLC: > Medicine, health > Preventive Medicine,Health > Health care organizations and career ( Health Management ) > Health Survey and Statistics > Health Statistics
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