Impact of Air Pollution on Health Care Management: Analytical Essay

Introduction

The term air pollution is referred to the interference of unwanted substances such as chemicals, particulate or biological materials which possess a threat (discomfort, severe diseases, death, and serious damage) to both living (man, animals, and plants) and non-living (water, soil, and air) things into the atmosphere via natural or anthropogenic (man-made) actions (Mahendra and Vaibhav 2013). These unwanted substances introduced into the atmosphere that can pose a serious threat to the environment, in general, are referred to as pollutants. Pollutants can be generated from natural processes such as (volcanic eruption, earthquakes, tornadoes, radon gas from radioactive decay within the earth's crust, and wildfire) or from anthropogenic activities such as (carbon monoxide gas from a motor vehicle exhaust, smokestacks of power plants, manufacturing facilities, waste deposition in landfills and military, such as nuclear weapons, toxic gases, germ warfare, and rocketry). According to (Mahendra and Vaibhav 2013), these pollutants can exist in various forms such as solid particulates, liquids effluents or discharges, and gaseous forms which could be classified as primary (Sulphur oxides (SOx), Nitrogen oxides (NOx), Carbon monoxide (CO), Volatile organic compounds (VOCs), Particulates, Persistent free radicals, Chlorofluorocarbons (CFCs), Ammonia (NH3), Odors, and Radioactive pollutants) or secondary (Particulates and Ground level ozone (O3)). Primary pollutants are emitted directly while secondary pollutants are created when there is an interaction or reaction between the primary pollutants with the atmosphere.

On the other hand, healthcare management involves and encompasses the collective efforts of healthcare managers in terms of planning, organizing, directing decision-making, and coordination of both clinical and non-clinical activities, direct and indirect care settings within healthcare systems, organizations, and networks. According to (Buchbinder and Thompson, 2010), direct care setting includes those organization that provides care to patients in need of health services, while indirect care setting do not provide the same services as direct care settings but rather give support to patients, residents or clients through products and services made available to direct care settings. Healthcare management is a branch of management that requires the managers to be very knowledgeable and expert in healthcare operations and technologies coupled with several leadership skills such as the ability to collaborate with multiple stakeholders, motivate team members, and proactively implement changes when necessary in the healthcare sector. The general duties of health care managers include (the development of the organization's goals and objectives; recruitment, supervising, and training of competent and qualified medical staff; ensuring strict adherence with patient privacy laws and other federal, state, and local regulations; identifying ways to improve health care services and increase operational sufficiency) amongst others. Healthcare management can be very tasking and complicated in terms of disasters (air, water, soil, and sediments pollution), pandemics (various diseases that can be contagious), and other forms of health-related emergency issues, which would require the healthcare manager to adapt rapidly to the changing circumstances, act quickly to high pressured situations and strategize an appropriate course of action based on the information obtained that will help the organization and limit reduce any adverse impacts to its barest minimum.

Air pollution is one of the major factors in healthcare management outcomes and healthcare expenditure. It has become an important issue of interest globally. According to (Pope, 2007), there is epidemiological evidence that suggests that most adverse health effects from air pollution are highly dependent on exposure length, and exposure concentrations of air pollutants. He also stated that long-term exposures have higher and more persistent cumulative effects than short-term exposures. Globally, ambient air pollution has been associated with a multitude of health effects, including changes in lung function, mortality, respiratory and cardiovascular hospitalizations, and asthma attacks. This in turn has imbibed more pressure on healthcare managers in terms, of planning and deciding the affairs of hospitals and clinics based on healthcare management (which falls into total healthcare expenditure, drug expenditure, diagnostic test expenditure, medical consumable expenditure, nursing expenditure, bed expenditure, blood expenditure, and antibiotic-consumption). Also, health care managers would be faced with a whole lot of challenges on how to control the influx of patients suffering from air polluted related diseases into health care centers and how to manage medical bills to be paid by patients as this can run down the medical center if the patient cannot afford medical bills or cannot get the proper treatments, especially in developing countries.

CASE STUDY: The Impact of Air Pollution on Healthcare Expenditure for Respiratory Diseases: Evidence from the People's Republic of China

Background: Air pollution is an important factor in health outcomes and healthcare expenditure. It has become an important issue of global concern. The objective of this study was to explore the influence of air pollution on the economic burden of respiratory diseases using different levels of PM2.5.

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Methods

Data Sources and Variable Selection

A total of 3,546 samples of data were collected from Beijing from 2013–2015. The samples obtained were from patients hospitalized in a tertiary hospital in Beijing between 2013 and 2015 in the Department of Respiratory and Critical Care Medicine. The data were in two sections. The first section was individual healthcare expenditure data sourced by the Department of Respiratory and Critical Care Medicine of the tertiary hospital. Healthcare expenditure is money spent on respiratory disease treatment. The second section was general air pollution data obtained from the website http: Beijing gair.sinaapp.com. The Beijing Municipal Environmental Monitoring Center is one of the earliest professional environmental monitoring agencies in China, and it is also a national environmental monitoring primary station.

Discussion

It was observed that air pollution had a great impact on healthcare expenditure. For a 1% increase in SO2 and soot emissions, public health expenditure increased by 0.15% and 0.79%, respectively. Zeng and He, (2019) based on a spatial econometric model, used panel data covering about 31 cities and provinces in China from 2002 to 2014 to investigate the relationship between industrial air pollution and healthcare management. Results obtained revealed that at the provincial level, industrial air pollution had a huge positive impact on healthcare expenditure. Also, a 1% increase in air pollution from industrial vent discharge in a province increased healthcare expenditure of neighboring provinces by 0.032% and 0.0072%, respectively. (Yang and Zhang 2018) in their studies utilized data from the China Urban Household Survey to estimate the impact of air pollution on expenditure. They found that with every 1% increase in PM2.5 concentration, medical expenditure increased by 2.942%. According to data sourced out from China Health and Retirement Longitudinal Survey, (Pi et al, 2019) utilized such data to give an account of the impact of air pollution on the healthcare expenditure of the elderly using ordinary least squares. The regression results obtained revealed that environmental pollution (PM10, S02, NO2) affected elderly health status and health status also affected medical insurance costs, which will indirectly affect healthcare expenditure. (Xu et al, 2019) in their studies utilized Bayesian quantile regression to estimate the impact of industrial waste gas emission on health expenditure based on panel data from 30 Chinese provinces between 2005–2016. The results obtained also revealed that industrial waste gas emissions significantly affected health care expenditure.

Another great observation was that air pollution is one of the main causes of increased healthcare expenditure via respiratory diseases. In the process of decreasing the burden of air pollution-related disease, it was suggested that the government should not only start from the supply side of healthcare services, such as reforming medical insurance payments, new technologies, and equipment, but should also focus on solving the demand side, such as by improving air quality, reducing environmental pollution, and improving residents’ health. Therefore, the formulation of policies must take into account both the supply and demand side of healthcare services.

However, air pollution increased the menace of respiratory diseases and worsened residents’ health status, in turn increasing healthcare expenditure. According to (Pi et al, 2019) the impact of PM10 and Air Quality Index (AQI) on the disease was basically consistent with the impact of PM2.5. Air pollution had a significant impact on healthcare expenditure on respiratory diseases. Which was one of the mechanisms by which air pollution affected the burden of disease. The effect of different levels of air pollution on the healthcare expenditure burden is heterogeneous (Pi et al, 2019). From the study, it was suggested that government should strengthen air- pollution control to ensure air quality is better, which can effectively reduce the impact of air pollution on health care expenditure. At the same time, the impact of air pollution on healthcare expenditure is different. The medical insurance system must play a key role. Differentiated reimbursement policies can be adopted to reduce the burden of disease on patients

Conclusion

To this end, it is obvious that air pollution really has a huge impact on health care management in terms of the economic burden of air pollution (respiratory) related diseases using the health care expenditure of patients as a milestone from medical centers. Healthcare managers are therefore faced with the challenges of strategizing and planning suitable ways to improve healthcare services, such as reforming medical insurance payments for patients, new technologies, and equipment that can be utilized in the treatment of air pollution-related diseases. Healthcare managers are also faced with thinking out ideas and working effortlessly with the government and environmental bodies on solving the demand side, such as improving air quality, solving environmental pollution, and improving the health of residents. This, therefore, has will boost the formulation of policies decided by healthcare managers into taking into account both the supply and the demand side of healthcare services.