空气污染，尤其是环境细颗粒物（PM2.5）污染，对公众健康构成重大风险，强调了在全国和次国家级别上了解其对健康负担和开支的长期影响的重要性。因此，本研究旨在量化台湾与PM2.5暴露相关的疾病负担和医疗开支，并评估减少污染水平的潜在效益。本研究采用综合风险评估框架结合自回归滑动平均模型，评估了包括缺血性心脏病、中风、慢性阻塞性肺病、肺癌和糖尿病在内的心肺疾病与相关医疗开支在不同空气质量目标情景下的可避免负担，包括现状和15、10、5μg/m3 PM2.5浓度减少的目标情景。我们的研究结果表明，减少PM2.5暴露有望显著减轻多种疾病的负担。比较2022年到2050年之间参照情景和目标情景之间的可归因疾病负担和医疗开支，15、10和5μg/m3目标情景下的可避免残疾调整生命年分别为61万、183万和319万。相应地，可避免的医疗开支范围从63亿美元到367亿美元不等。我们还强调了资源不平等分配的问题，以及需要政策干预来解决由空气污染引起的健康差距。值得注意的是，在5μg/m3目标情景下，高雄市将获得最大收益，2022年到2050年间的残疾调整生命年减少为527,368，节省的费用为0.53亿美元。我们的研究结果表明，采用更严格的排放目标可以有效降低台湾的健康负担和相关医疗开支。总体而言，本研究为台湾的决策者提供了有关通过建立评估空气污染减少对医疗开支和疾病负担的共同利益的综合框架来缓解空气污染的负面影响的宝贵见解。版权所有©2023，由爱思唯尔公司出版。

Air pollution, particularly ambient fine particulate matter (PM2.5) pollution, poses a significant risk to public health, underscoring the importance of comprehending the long-term impact on health burden and expenditure at national and subnational levels. Therefore, this study aims to quantify the disease burden and healthcare expenditure associated with PM2.5 exposure in Taiwan and assess the potential benefits of reducing pollution levels. Using a comparative risk assessment framework that integrates an auto-aggressive integrated moving average model, we evaluated the avoidable burden of cardiopulmonary diseases (including ischemic heart disease, stroke, chronic obstructive pulmonary disease, lung cancer, and diabetes mellitus) and related healthcare expenditure under different air quality target scenarios, including status quo and target scenarios of 15, 10, and 5 μg/m3 reduction in PM2.5 concentration. Our findings indicate that reducing PM2.5 exposure has the potential to significantly alleviate the burden of multiple diseases. Comparing the estimated attributable disease burden and healthcare expenditure between reference and target scenarios from 2022 to 2050, the avoidable disability-adjusted life years were 0.61, 1.83, and 3.19 million for the 15, 10, and 5 μg/m3 target scenarios, respectively. Correspondingly, avoidable healthcare expenditure ranged from US$ 0.63 to 3.67 billion. We also highlighted the unequal allocation of resources and the need for policy interventions to address health disparities due to air pollution. Notably, in the 5 μg/m3 target scenario, Kaohsiung City stands to benefit the most, with 527,368 disability-adjusted life years avoided and US$ 0.53 billion saved from 2022 to 2050. Our findings suggest that adopting stricter emission targets can effectively reduce the health burden and associated healthcare expenditure in Taiwan. Overall, this study provides policymakers in Taiwan with valuable insights for mitigating the negative effects of air pollution by establishing a comprehensive framework for evaluating the co-benefits of air pollution reduction on healthcare expenditure and disease burden.Copyright © 2023. Published by Elsevier Ltd.