{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T06:04:39Z","timestamp":1789365879066,"version":"build-2803163510"},"reference-count":34,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T00:00:00Z","timestamp":1789344000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"\n Background<\/jats:title>\n Ambient air pollution poses substantial cardiovascular health and economic burdens worldwide, yet existing evidence largely focuses on high-pollution regions and clinical endpoints such as incidence or mortality. Few studies have quantified air pollution-attributable hospitalization costs for acute myocardial infarction (AMI), especially under low air quality conditions. Combined with China's Diagnosis-Related Groups (DRG) \/ Diagnosis-Intervention Packet (DIP) case-mix medical payment reform, hospitalization expenses can serve as a reliable proxy reflecting AMI disease severity and healthcare resource consumption, providing a unique health-economic perspective for environmental public health policy-making.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n A single-center retrospective cohort study was conducted including 3,650 percutaneous coronary intervention (PCI)-treated AMI patients admitted to Jiangmen Central Hospital (2018\u20132024), a subtropical city with year-round air pollutant concentrations meeting China Grade II standards. Lag-stratified Gamma generalized linear models with log link were applied to evaluate associations between pre-admission 0\u20136 day exposure to six criteria pollutants (PM\n 2.5<\/jats:sub>\n , PM\n 10<\/jats:sub>\n , SO\n 2<\/jats:sub>\n , NO\n 2<\/jats:sub>\n , CO, O\n 3<\/jats:sub>\n ) and AMI hospitalization costs. All single-pollutant models were fully adjusted for demographics, comorbidities, seasons, weekdays, and non-linear meteorological confounders. Benjamini\u2013Hochberg false discovery rate (FDR) correction was used to control multiple testing bias. A sensitivity analysis restricted to 1,590 never-smoking patients was performed.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Short-term exposure to SO\n 2<\/jats:sub>\n , PM\n 2.5<\/jats:sub>\n , PM\n 10<\/jats:sub>\n , NO\n 2<\/jats:sub>\n , and CO was significantly associated with elevated AMI medical expenditures, while O\n 3<\/jats:sub>\n showed no overall significant correlation. Per natural log-unit elevation, SO\n 2<\/jats:sub>\n generated the largest cost increase (average 2.40%, ~729 CNY) with consistent adverse effects across all lag days; particulate pollutants PM\n 2.5<\/jats:sub>\n and PM\n 10<\/jats:sub>\n exhibited delayed peak risks at lag 4\u20135 days. In never-smokers, O\n 3<\/jats:sub>\n triggered significant cost rises at lag 3 and lag 5, indicating non-smokers as vulnerable subgroups susceptible to ozone toxicity. Multicollinearity diagnostics validated the rationality of single-pollutant modeling.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n Even low-level ambient air pollution compliant with current national standards increases the economic burden of AMI treatment, with SO\n 2<\/jats:sub>\n showing the strongest association. Smoking modifies cardiovascular cost-related effects of ozone. This population-level health-economic evidence supports stricter air quality regulations, and the integration of ambient exposure indicators into AMI risk stratification and public health resource allocation under the DRG\/DIP payment system.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1939605","type":"journal-article","created":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T05:40:18Z","timestamp":1789364418000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Short-term lagged exposure to ambient air pollutants and hospitalization costs among AMI patients: health-economic evidence from a low-pollution Chinese city with DRG\/DIP standardized medical payment"],"prefix":"10.3389","volume":"14","author":[{"given":"Junming","family":"Lin","sequence":"first","affiliation":[{"name":"Emergency Department, Jiangmen Central Hospital","place":["Jiangmen, 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