International Journal of Biometeorology

, Volume 56, Issue 1, pp 121–127 | Cite as

Weather conditions and visits to the medical wing of emergency rooms in a metropolitan area during the warm season in Israel: a predictive model

  • Ilya Novikov
  • Ofra Kalter-Leibovici
  • Angela Chetrit
  • Nir Stav
  • Yoram Epstein
Original Paper


Global climate changes affect health and present new challenges to healthcare systems. The aim of the present study was to analyze the pattern of visits to the medical wing of emergency rooms (ERs) in public hospitals during warm seasons, and to develop a predictive model that will forecast the number of visits to ERs 2 days ahead. Data on daily visits to the ERs of the four largest medical centers in the Tel-Aviv metropolitan area during the warm months of the year (April–October, 2001–2004), the corresponding daily meteorological data, daily electrical power consumption (a surrogate marker for air-conditioning), air-pollution parameters, and calendar information were obtained and used in the analyses. The predictive model employed a time series analysis with transitional Poisson regression. The concise multivariable model was highly accurate (r 2 = 0.819). The contribution of mean daily temperature was small but significant: an increase of 1°C in ambient temperature was associated with a 1.47% increase in the number of ER visits (P < 0.001). An increase in electrical power consumption significantly attenuated the effect of weather conditions on ER visits by 4% per 1,000 MWh (P < 0.001). Higher daily mean SO2 concentrations were associated with a greater number of ER visits (1% per 1 ppb increment; P = 0.017). Calendar data were the main predictors of ER visits (r 2 = 0.794). The predictive model was highly accurate in forecasting the number of visits to ERs 2 days ahead. The marginal effect of temperature on the number of ER visits can be attributed to behavioral adaptations, including the use of air-conditioning.


Urban Heat Island Behavioral Adaptation Electrical Power Consumption Absolute Relative Error Calendar Data 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



We thank the emergency room directors: Dr. Pinchas Halperin, Tel-Aviv Sourasky Medical Center, and Dr. Zvi Rottenberg, Rabin Medical Center; and Prof. Zeev Rotstein, director of the Sheba Medical Center, and Dr Itzhak Berlowitz, director of Wolfson Medical Center, for provision of healthcare utilization data.


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Copyright information

© ISB 2011

Authors and Affiliations

  • Ilya Novikov
    • 1
  • Ofra Kalter-Leibovici
    • 2
    • 3
  • Angela Chetrit
    • 2
  • Nir Stav
    • 4
  • Yoram Epstein
    • 3
    • 5
  1. 1.Unit of BiostatisticsGertner Institute for Epidemiology & Health Policy ResearchTel HashomerIsrael
  2. 2.Unit of Cardiovascular EpidemiologyGertner Institute for Epidemiology & Health Policy ResearchTel HashomerIsrael
  3. 3.Sackler Faculty of MedicineTel Aviv UniversityTel HashomerIsrael
  4. 4.National Meteorological ServicesBeit DaganIsrael
  5. 5.Heller Institute of Medical ResearchSheba Medical CenterTel HashomerIsrael

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