Novel Method for Measuring Ambient Heat Exposure-Acute Healthcare Utilization Associations Within a Safety Net: A
Elizabeth Gillespie1,2, Abigail Steiner3, Josh Durfee3
1Denver Health Medical Center, Denver, CO, USA. Elizabeth.Gillespie@dhha.org.
Journal of General Internal Medicine
|December 11, 2024
Summary
Extreme heat significantly increases healthcare utilization for individuals with heat-sensitive conditions. Targeted interventions can mitigate heat-related illness and reduce healthcare use among vulnerable populations.
Area of Science:
- Environmental Health
- Public Health
- Clinical Medicine
Background:
- Extreme heat events pose significant public health risks, leading to weather-related mortality.
- Individual-level healthcare utilization patterns during extreme heat are not well understood.
Purpose of the Study:
- To compare demographic and clinical factors associated with healthcare utilization during high-temperature periods (HHP) versus low-temperature periods (LHP).
Main Methods:
- A 5-year retrospective study analyzed acute care utilization comparing HHP and LHP.
- Patients aged 4+ years with at least two visits over 365 days were included.
- Utilization rates were compared using Poisson regression, adjusted for covariates and heat vulnerability.
Main Results:
- While overall utilization was similar or higher in LHP, certain groups (Native Americans, those with heart/liver failure, alcohol use) showed higher HHP utilization.
- Age, sex, race/ethnicity, clinical conditions, and neighborhood heat vulnerability were associated with utilization.
- Individuals with heat-sensitive conditions had significantly higher HHP vs LHP utilization (aIRR=1.93).
Conclusions:
- Heat-sensitive clinical conditions are linked to significant heat-related healthcare utilization.
- Demographics and specific conditions like liver failure increase vulnerability.
- Proactive chronic disease management can identify at-risk individuals for heat-related interventions.
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