Conditions

Which conditions?

The change in total visits is a net figure, and the net hides opposite movements by diagnosis. After a cold day, infectious and parasitic visits fall 82.5% over 30 days while respiratory visits rise 33.6%. After a hot day, endocrine and metabolic visits rise 10.3% on the day and circulatory visits fall 3.2%.

Every diagnostic chapter, at the interval and horizon you choose

Temperature:
Horizon:
-80-60-40-200+20+40Change in ED visits for that chapter (%)Visits per 100,000Infectious and parasiticInfectious and parasitic: 3.954 per 100,000−17.0%−82.5%−9.9%−49.5%−5.0%−19.0%+5.0%+6.4%+8.6%−7.4%Blood and immuneBlood and immune: 0.215 per 100,000−8.7%−36.4%−5.7%−24.5%−3.3%−17.5%+0.9%+10.5%+1.6%+22.3%External causesExternal causes: 8.052 per 100,000−14.0%−34.8%−8.4%−24.0%−4.2%−12.2%+4.3%+9.7%+5.7%+12.6%NeoplasmsNeoplasms: 0.275 per 100,000−6.1%−32.2%−3.2%−16.6%−1.5%−4.6%−0.4%+3.1%−2.6%−0.1%DigestiveDigestive: 3.969 per 100,000−7.1%−29.6%−3.5%−20.7%−1.7%−7.4%+0.1%+3.1%−0.1%+4.3%GenitourinaryGenitourinary: 3.107 per 100,000−8.7%−29.6%−4.9%−24.9%−2.8%−11.4%+2.6%+12.3%+4.8%+21.0%Skin and musculoskeletalSkin and musculoskeletal: 2.449 per 100,000−11.0%−28.0%−5.6%−21.4%−2.6%−8.8%+1.9%+8.2%+1.5%+15.7%Mental healthMental health: 0.705 per 100,000−14.0%−24.9%−8.6%−16.2%−4.4%−6.7%+4.8%+4.1%+8.9%+6.1%OtherOther: 10.707 per 100,000−7.4%−21.2%−5.1%−17.5%−2.6%−8.1%+2.9%+8.3%+4.1%+7.2%Nervous systemNervous system: 0.608 per 100,000−12.6%−20.0%−6.4%−8.8%−2.8%−4.1%+1.8%+4.4%+0.2%+6.5%ObstetricObstetric: 4.641 per 100,000−4.7%−13.0%−3.2%−7.4%−1.8%−2.7%+1.9%+7.5%+4.0%+7.7%Endocrine and metabolicEndocrine and metabolic: 1.581 per 100,000−14.6%−11.2%−9.0%−10.1%−4.7%−4.3%+4.3%+5.3%+10.3%+19.6%Eye and earEye and ear: 0.897 per 100,000−6.0%+2.2%−2.0%+3.3%−0.6%+1.3%+1.7%+5.8%+1.9%+9.6%CirculatoryCirculatory: 1.744 per 100,000−5.9%+2.5%−1.5%0.0%−0.6%−0.1%−0.7%−3.9%−3.2%−6.4%RespiratoryRespiratory: 9.15 per 100,000−7.3%+33.6%−3.7%+25.8%−1.7%+13.2%+0.7%−11.3%+1.1%−31.2%
Rows are ordered by the cumulative effect of a day below 10 °C and stay in that order as you change interval or horizon, so a single condition can be tracked across states. Bars beside each label show baseline volume on a shared scale. Whiskers are 95% confidence intervals.
Estimates behind this figure:m4_chapters.csv
Full dataCode

When looking at the effect of a very cold day (mean temperature below 10 °C) on the same day, 15 of 15 chapters fall significantly, infectious and parasitic the most at 17.0%; respiratory falls 7.3%, and no chapter rises.

When looking at the cumulative effect of a very cold day over the following 30 days, 12 chapters fall significantly, from 11.2% (endocrine and metabolic) to 82.5% (infectious and parasitic), and 2 show no significant change. Respiratory rises 33.6%, consistent with infections spreading after cold exposure.

When looking at the effect of a very hot day (mean temperature above 30 °C) on the same day, endocrine and metabolic (+10.3%), mental (+8.9%), infectious and parasitic (+8.6%) and external causes (+5.7%) rise most. Circulatory visits fall 3.2%, the only chapter to do so; the paper's mechanism section discusses why.

When looking at the cumulative effect of a very hot day over the following 30 days, blood and immune (+22.3%), genitourinary (+21.0%), endocrine and metabolic (+19.6%) and external causes (+12.6%) keep rising. Respiratory reverses to −31.2%, infectious and parasitic to −7.4%, and circulatory deepens to −6.4%.

What is being estimated

Each chapter is a separate Poisson distributed lag model with 30 lags, fitted to visits assigned to that ICD-10 chapter, and measured against a day between 20 and 25 °C.

Row order is fixed by the cumulative effect of a day below 10 °C and does not change with the controls, so a condition can be followed across states.

Baseline volume is the mean outcome reported in the paper, in visits per 100,000 people. Whiskers are 95% confidence intervals, clustered at the municipality level.