温度変化がNHS医療費に及ぼす影響を定量化(New study estimates NHS England spends 3% of its primary and secondary care budget on the health impacts of temperature)

2025-12-24

2025-12-23 オックスフォード大学

オックスフォード大学の研究チームは、NHSイングランドが一次・二次医療の予算の約3%を、医療上の価値が限定的または不要と考えられる医療行為に費やしていると推計した。これは年間で数十億ポンド規模に相当する可能性がある。研究では、過剰検査や過剰治療、効果が十分に裏付けられていない処置などを分析対象とし、臨床的有用性とコストの関係を評価した。その結果、こうした低価値医療を削減できれば、医療従事者の負担軽減や待機時間の短縮、より効果的な医療への再投資が可能になると指摘している。研究者らは、医療の質を損なうことなく支出効率を高めるためには、エビデンスに基づく診療指針の徹底や、政策レベルでの意思決定支援が重要だと強調している。この研究は、医療費高騰が続く中で、限られた医療資源をどのように最適配分するかという課題に重要な示唆を与えている。

<関連情報>

イングランド国民保健サービスにおける気温の医療負担の定量化:資源使用と費用の経済分析 Quantifying the health-care burden of temperature in the National Health Service in England: an economic analysis of resource use and costs

Patrick Fahr, DPhil ∙ Francois Cohen, PhD ∙ Jessica Schiff, SM ∙ Anant Jani, PhD ∙ Mateo Petel, MSc ∙ Prof Malcolm McCulloch, PhD ∙ et al.
The Lancet Planetary Health Published: December 18, 2025
DOI:https://doi.org/10.1016/j.lanplh.2025.101373

Summary

Background

Climate change poses a severe and escalating threat to human health, yet its broader implications for health-care systems remain poorly understood. Although previous studies have examined mortality and hospital admissions, crucial domains such as medical prescriptions and system-wide costs have been overlooked. This study aims to provide the first comprehensive analysis of the impact of daily average temperature variability on a national health-care system.

Methods

In this economic analysis of resource use and costs, we analysed 4 366 981 patient records from the National Health Service (NHS) in England from the Clinical Practice Research Datalink GOLD, from April 1, 2007, to June 1, 2019. We sourced weather data from the Met Office HadUK-Gridded climate observations. We used a fixed-effects regression model, aligned with methodologies used in other climate-health studies, to estimate the temperature–health-care relationship while controlling for seasonality and practice-specific characteristics. Outcomes included daily counts of health-care events and associated costs per 1000 general-practice-registered individuals, stratified by age, sex, and care domains. We conducted additional robustness checks using alternative lag structures and model specifications.

Findings

Colder days (average temperature 0°C to 9°C) were associated with cumulative increases in consultations with general practitioners, inpatient admissions, and deaths, with disproportionately larger effects among older adults (age >65 years). In contrast, attendance to the Accident and Emergency (A&E) department declined on cold days. Very hot days (>23°C) produced sharp same-day surges in A&E attendances and prescriptions, but cumulative effects were attenuated once the dips in the following days were included. Overall, suboptimal temperature exposure accounted for 3·0% (95% CI 1·2–4·7) of total health-care expenditure, with cold driving 64·4% of this burden. Robustness checks confirmed that these results were stable across alternative model specifications and lag structures.

Interpretation

Temperature variability disrupts health-care delivery, straining service capacity during busy periods. These findings provide the first system-wide benchmark for understanding the health burden of temperature, highlighting potential discrepancies between mortality and access to care. Globally, health-care systems must anticipate these disruptions, and adaptation policies outside of health-care systems are essential to reduce health and financial pressures. Investments in climate-resilient infrastructure and strategies to protect vulnerable populations, especially older adults, are urgently needed.