Using detailed data on the beneficiaries of the Korean National Health Insurance Service (c.2006–2015), this paper estimates the health effects of air pollution in South Korea while controlling for avoidance behaviors. In particular, we investigate changes in respiratory hospitalization rates due to increases in PM\(_{10}\) and O\(_{3}\) concentrations. To address the endogeneity of air pollution, this paper applies the historical average concentration of air pollution, which includes rich information about the meteorological and geographical factors that affect regional air pollution levels, as an instrumental variable and compares the results with other count data models. We find that a 10 \(\upmu\)g/m\(^{3}\) increase in PM\(_{10}\) and a 10 ppb increase in O\(_{3}\) lead to an increase in daily respiratory hospital visits of up to 10.39% [95% confidence interval (CI) 4.04–16.80] and 10.93% (95% CI 9.23–12.63), resulting in additional health care costs of US$67 million and US$70 million, respectively. This paper also shows that the effects of PM\(_{10}\) and O\(_{3}\) are elevated in highly populated cities, children, and patients without chronic respiratory diseases.

本文使用有关韩国国民健康保险服务受益人的详细数据（c.2006–2015），在控制逃避行为的同时，估算了韩国空气污染对健康的影响。特别是，我们调查了由于PM \（_ {10} \）和O \（_ {3} \）浓度增加而导致的呼吸住院率的变化。为了解决空气污染的内生性，本文将空气污染的历史平均浓度作为一种工具变量，将影响区域空气污染水平的气象和地理因素的丰富信息作为工具变量，并将其结果与其他计数数据模型进行比较。我们发现PM增加10  \（\ upmu \） g / m \ {^ {3} \）\（_ {10} \）和O \（_ {3} \）的增加10 ppb导致每天呼吸内科就诊次数增加高达10.39％[95％置信区间（CI）4.04–16.80]和10.93％（95％CI 9.23–12.63），导致额外的医疗保健费用分别为6,700万美元和7,000万美元。本文还显示，在人口稠密的城市，儿童和无慢性呼吸道疾病的患者中，PM （_ {10} \）和O （_ {3} \）的影响增加。