1
|
The value of walking: a systematic review on mobility and healthcare costs. Eur Rev Aging Phys Act 2022; 19:31. [PMID: 36581809 PMCID: PMC9798720 DOI: 10.1186/s11556-022-00310-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 12/03/2022] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND The ability to walk is an important indicator of general health and mobility deficits have wide-ranging economic implications. We undertook a systematic review to elucidate the impact of walking parameters on health care costs. METHODS: Publications reporting on associations between health care costs and walking parameters were identified by a systematic literature search in MEDLINE, Embase, and manual reference screening, following the PRISMA reporting guidelines. First, titles and abstracts were screened by two independent reviewers followed by a review of the full articles if they met the inclusion criteria. Costs were converted to US-Dollars with inflation adjustment for 2021. A narrative synthesis was performed. RESULTS: Ten studies conducted between 2001 and 2021 fulfilled the inclusion criteria. Assessment of walking ability was carried out via patient reported outcomes, performance tests, or using wearable digital devices. Walking more than one hour per day, a faster walking speed and the ability to walk without impairments are associated with significant lower health care costs. A higher number of steps per day is associated with significant lower costs in two simulation studies, while in the study using a digital device, taking more than 10,000 steps per day is not significantly associated with lower direct costs. The heterogeneity of mobility assessments and of economic analyses both precluded a quantitative synthesis. CONCLUSION Cross-sectional and observational studies from this systematic review suggest a significant association of better walking performance with lower health care costs. Future health economic research and health technology assessments should use quantifiable mobility outcomes when evaluating new drugs or non-pharmacological interventions.
Collapse
|
2
|
Andersen P, Holmberg S, Årestedt K, Lendahls L, Nilsen P. Factors associated with increased physical activity among patients prescribed physical activity in Swedish routine health care including an offer of counselor support: a 1-year follow-up. BMC Public Health 2022; 22:509. [PMID: 35292017 PMCID: PMC8925134 DOI: 10.1186/s12889-022-12940-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 03/03/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The study addresses knowledge gaps in research regarding influences of routine health care delivery of physical activity on prescription (PAP). The aim was to investigate if patient and health care characteristics are associated with increased physical activity 1 year after prescription among patients offered counselor support in addition to health care professionals' prescription. The study was conducted in primary and secondary care in a Swedish health care region. METHODS All PAP recipients during 1 year were invited (N = 1503) to participate in this observational prospective study. Data were collected from medical records and questionnaires (baseline and follow-up). Descriptive statistics and multiple logistic regression analysis were used. The outcome variable was increased physical activity after 1 year. Study variables were patient and health care characteristics. RESULTS Three hundred and fifty-five patients with complete follow-up data were included. The mean age was 62 years (SD = 14; range, 18-90) and 68% were females. Almost half (47%) had increased physical activity 1 year after PAP. Multiple logistic regression analysis showed that increased physical activity at follow-up was positively associated with lower baseline activity, counselor use, and positive perception of support. Counselor users with low baseline activity had higher odds ratio for increased physical activity at follow-up than non-users (OR = 7.2, 95% CI = 2.2-23.5 vs. OR = 3.2, 95% CI = 1.4-7.5). Positive perception of support was associated with increased physical activity among counselor users but not among non-users. CONCLUSIONS An increase in physical activity after PAP was related to low baseline activity, positive perception of support, and use of counselor support after PAP. Qualified counseling support linked to PAP seems to be important for achieving increased physical activity among patients with lower baseline activity.
Collapse
Affiliation(s)
- Pia Andersen
- Department of Research and Development, Region Kronoberg, SE-351 88, Växjö, Sweden. .,Department of Health, Medicine and Caring Sciences, Division of Society and Health, Linköping University, SE-581 83, Linköping, Sweden.
| | - Sara Holmberg
- Department of Research and Development, Region Kronoberg, SE-351 88, Växjö, Sweden.,Division of Occupational and Environmental Medicine, Institute of Laboratory Medicine, Lund University, SE-221 00, Lund, Sweden.,Faculty of Health and Life Sciences, Department of Medicine and Optometry, Linnaeus University, SE-391 82, Kalmar, Sweden
| | - Kristofer Årestedt
- Faculty of Health and Life Sciences, Department of Health and Caring Sciences, Linnaeus University, SE-391 82, Kalmar, Sweden.,The Research Section, Region Kalmar County, SE-391 26, Kalmar, Sweden
| | - Lena Lendahls
- Department of Research and Development, Region Kronoberg, SE-351 88, Växjö, Sweden.,Faculty of Health and Life Sciences, Department of Health and Caring Sciences, Linnaeus University, SE-391 82, Kalmar, Sweden
| | - Per Nilsen
- Department of Health, Medicine and Caring Sciences, Division of Society and Health, Linköping University, SE-581 83, Linköping, Sweden
| |
Collapse
|
3
|
Lopez-de-Andres A, de Miguel-Diez J, Hernandez-Barrera V, Jiménez-Trujillo I, Martinez-Huedo MA, Del Barrio JL, Jimenez-Garcia R. Effect of the economic crisis on the use of health and home care services among elderly Spanish diabetes patients. Diabetes Res Clin Pract 2018; 140:27-35. [PMID: 29601915 DOI: 10.1016/j.diabres.2018.03.033] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Revised: 01/03/2018] [Accepted: 03/20/2018] [Indexed: 11/22/2022]
Abstract
AIMS To describe the utilization of health and home care services among older people (≥65 years) with diabetes during the economic crisis; to identify the factors associated with changes in the utilization of these services; and to study the time trends (2009-2014). METHODS We used the European Health Interview Surveys for Spain (EEHSS) for 2009/10 and 2014. The dependent variables included self-reported hospitalizations; general practitioner (GP) visits; 'other healthcare services' (OHS) used; and home care services (HCS) used. RESULTS We identified 6026 and 6020 diabetic patients (EEHSS2009 and EEHSS2014, respectively). A significant decrease in the number of GP visits (OR 0.94; 95% CI 0.91-0.98) and the use of HCS (OR 0.95; 95% CI 0.91-0.99) was found; however, we found an increase in the use of OHS (OR 1.06; 95% CI 1.02-1.10). Multivariate models showed that factors associated with an increased use included chronic conditions, worse self-rated health, pain and mental disorders. Physical activity was a strong predictor of lower hospitalizations and HCS use. Female gender was associated with significantly lower hospitalizations and a higher use of OHC and HCS. CONCLUSION We found a decrease in the number of GP visits and the use of HCS among elderly diabetic adults; however, we also observed an increase in the use of OHS, which may partly explain this decrease in the figures. Significant differences in the use of health services were found according to gender. The effect of the economic crisis, if any, seems to have had a small magnitude.
Collapse
Affiliation(s)
- Ana Lopez-de-Andres
- Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Rey Juan Carlos University, Alcorcón, Comunidad de Madrid, Spain.
| | - Javier de Miguel-Diez
- Pneumology Department, Hospital General Universitario Gregorio Marañón, Universidad Complutense de Madrid, Comunidad de Madrid, Spain
| | - Valentin Hernandez-Barrera
- Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Rey Juan Carlos University, Alcorcón, Comunidad de Madrid, Spain
| | - Isabel Jiménez-Trujillo
- Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Rey Juan Carlos University, Alcorcón, Comunidad de Madrid, Spain
| | - Maria-Angeles Martinez-Huedo
- Preventive Medicine and Public Health, Unidad de Docencia, Hospital Universitario La Paz, Madrid, Comunidad de Madrid, Spain
| | - José Luis Del Barrio
- Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Rey Juan Carlos University, Alcorcón, Comunidad de Madrid, Spain
| | - Rodrigo Jimenez-Garcia
- Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Rey Juan Carlos University, Alcorcón, Comunidad de Madrid, Spain
| |
Collapse
|
4
|
de Miguel-Diez J, Lopez-de-Andres A, Herandez-Barrera V, Jimenez-Trujillo I, Puente-Maestu L, Cerezo-Lajas A, Jimenez-Garcia R. Effect of the economic crisis on the use of health and home care services among Spanish COPD patients. Int J Chron Obstruct Pulmon Dis 2018. [PMID: 29535513 PMCID: PMC5836665 DOI: 10.2147/copd.s150308] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Background Chronic obstructive pulmonary disease (COPD) is a major cause of disability and death worldwide. Consequently, COPD patients are frequent users of health and social resources. Therefore, they are highly vulnerable to decreases in investment in healthcare services. We aimed to describe the utilization of health and home care services among Spanish COPD patients during the economic crisis to identify factors independently associated with changes in the utilization of these services and to study the time trends from 2009 to 2014. Methods We used data from the European Health Interview Surveys for Spain (EHSS) conducted between 2009/2010 (n=22,188) and 2014 (n=22,842). We included responses from adults with COPD aged 40 years or over. Dependent variables included self-reported hospitalizations during the previous year, general practitioner (GP) visits during the last 4 weeks, other health care services used during the previous year (nursing, rehabilitation, and psychological services), and home care services use during the previous year. Independent variables included demographic and socioeconomic characteristics, health status variables, and lifestyles. Results We identified 1,328 and 1,008 COPD patients from EHSS 2009 and EHSS 2014, respectively. We observed a significant increase in non-GP services use (30.6% in 2009 vs 39.11% in 2014; p<0.001). No changes were found for hospitalizations, GP visits, and home care services use over time. Multivariable models showed that associated factors with a higher use included any chronic comorbidity and worse self-rated health. Physical activity was a strong predictor of fewer hospitalizations and less home care service use. Female sex was associated with significantly fewer hospitalizations (OR 0.72; 95% CI 0.58-0.89). Conclusion We found an increase in the use of non-GP services (nursing, rehabilitation, and psychological) but not in other health and home care services. The only differences in hospitalizations were observed according to sex. Therefore, the effect of the economic crisis, if any, seems to have been of small magnitude.
Collapse
Affiliation(s)
- Javier de Miguel-Diez
- Respiratory Department, Hospital General Universitario Gregorio Marañón, Facultad de Medicina, Universidad Complutense de Madrid (UCM), Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
| | - Ana Lopez-de-Andres
- Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
| | - Valentin Herandez-Barrera
- Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
| | - Isabel Jimenez-Trujillo
- Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
| | - Luis Puente-Maestu
- Respiratory Department, Hospital General Universitario Gregorio Marañón, Facultad de Medicina, Universidad Complutense de Madrid (UCM), Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
| | - Alicia Cerezo-Lajas
- Respiratory Department, Hospital General Universitario Gregorio Marañón, Facultad de Medicina, Universidad Complutense de Madrid (UCM), Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
| | - Rodrigo Jimenez-Garcia
- Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
| |
Collapse
|
5
|
Marsh AP, Applegate WB, Guralnik JM, Jack Rejeski W, Church TS, Fielding RA, Gill TM, King AC, Kritchevsky SB, Manini TM, McDermott MM, Newman AB, Stowe CL, Walkup MP, Pahor M, Miller ME. Hospitalizations During a Physical Activity Intervention in Older Adults at Risk of Mobility Disability: Analyses from the Lifestyle Interventions and Independence for Elders Randomized Clinical Trial. J Am Geriatr Soc 2017; 64:933-43. [PMID: 27225353 DOI: 10.1111/jgs.14114] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVES To determine whether moderate-intensity physical activity (PA) and health education (HE) are differentially associated with categories of hospitalizations or subgroups of participants. DESIGN Multicenter randomized controlled trial in which participants were randomized to a PA or HE program for an average of 2.6 years. SETTING Eight field centers. PARTICIPANTS Sedentary men and women aged 70-89 with lower extremity physical limitations but able to walk 400-m in 15 minutes or less (N = 1,635). INTERVENTIONS Structured, moderate-intensity PA (n = 818) at a center (2×/wk) and at home (3-4×/wk) that included aerobic, strength, balance, and flexibility training or HE (n = 817) of educational workshops and upper extremity stretching exercises. MEASUREMENTS All-cause inpatient hospitalizations ascertained at 6-month intervals. RESULTS There were 1,458 hospitalizations (49.1% of PA, 44.4% of HE; risk difference = 4.68%, 95% confidence interval (CI) = -0.18-9.54; hazard ratio (HR) = 1.16, 95% CI = 1.00-1.34). The intervention effect on incident hospitalization did not differ according to race, sex, Short Physical Performance Battery score, age, or history of cardiovascular disease or diabetes mellitus. PA was associated with higher rates of hospitalization in the middle baseline gait speed category, than HE (<0.8 m/s: HR = 0.93, 95% CI = 0.76-1.14; 0.8-1.0 m/s: HR = 1.54, 95% CI = 1.23-1.94; >1.0 m/s: HR = 1.05, 95% CI = 0.67-1.65; interaction P = .005). CONCLUSION A PA program in older adults at risk for mobility disability did not lead to a different risk of specific types of hospitalizations than a HE program overall. Baseline gait speed may be a marker for risk of hospitalization during a PA intervention, because individuals with moderate baseline gait speed in the PA group had slightly higher rates of hospitalization than those in the HE group. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT01072500.
Collapse
Affiliation(s)
- Anthony P Marsh
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, North Carolina
| | - William B Applegate
- Section on Gerontology and Geriatric Medicine, Department of Internal Medicine, Sticht Center on Aging, Wake Forest University, Winston-Salem, North Carolina
| | - Jack M Guralnik
- Division of Gerontology, Department of Epidemiology and Public Health, School of Medicine, University of Maryland, Baltimore, Maryland
| | - W Jack Rejeski
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, North Carolina
| | - Timothy S Church
- Division of Gerontology, Department of Epidemiology and Public Health, School of Medicine, University of Maryland, Baltimore, Maryland
| | - Roger A Fielding
- Nutrition, Exercise Physiology, and Sarcopenia Laboratory, Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts
| | - Thomas M Gill
- Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut
| | - Abby C King
- Department of Health Research and Policy, School of Medicine, Stanford University, Stanford, California.,Department of Medicine, School of Medicine, Stanford University, Stanford, California
| | - Stephen B Kritchevsky
- Section on Gerontology and Geriatric Medicine, Department of Internal Medicine, Sticht Center on Aging, Wake Forest University, Winston-Salem, North Carolina
| | - Todd M Manini
- Department of Aging and Geriatric Research, Institute on Aging, College of Medicine, University of Florida, Gainesville, Florida.,Department of Medicine and Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Mary M McDermott
- Department of Aging and Geriatric Research, Institute on Aging, College of Medicine, University of Florida, Gainesville, Florida.,Department of Medicine and Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Anne B Newman
- Department of Epidemiology and Medicine, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Cynthia L Stowe
- Division of Public Health Sciences, Department of Biostatistical Sciences, School of Medicine, Wake Forest University, Winston-Salem, North Carolina
| | - Michael P Walkup
- Division of Public Health Sciences, Department of Biostatistical Sciences, School of Medicine, Wake Forest University, Winston-Salem, North Carolina
| | - Marco Pahor
- Department of Aging and Geriatric Research, Institute on Aging, College of Medicine, University of Florida, Gainesville, Florida.,Department of Medicine and Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Michael E Miller
- Division of Public Health Sciences, Department of Biostatistical Sciences, School of Medicine, Wake Forest University, Winston-Salem, North Carolina
| | | |
Collapse
|
6
|
Ku PW, Steptoe A, Chen YH, Chen LJ, Lin CH. Prospective association between late-life physical activity and hospital care utilisation: a 7-year nationwide follow-up study. Age Ageing 2017; 46:452-459. [PMID: 27852596 DOI: 10.1093/ageing/afw202] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2016] [Accepted: 10/03/2016] [Indexed: 11/12/2022] Open
Abstract
Background it is still equivocal whether there is a potential role of late-life physical activity in ameliorating the challenges of increasing healthcare expenditure due to the consequence of global population ageing. Objective this study aimed to examine the prospective association between physical activity and subsequent hospital care utilisation in older adults and to explore the optimal dose of physical activity required to reduce hospital care utilisation. Design this was a prospective cohort study based on the data from the Taiwan 2005 National Health Interview Survey, which were linked to the 2005-12 claims data from the National Health Insurance system. Participants 1,760 older adults aged 65 or more. Methods the frequency, duration and intensity for physical activity were assessed, and total physical activity energy expenditure was estimated. The average annualised hospital care utilisation for the period 2006 through 2012, including number of hospitalisations, number of days in hospital and the costs of hospitalisation, were calculated. Results older adults engaging in at least moderate volume of physical activity (≥1,000 kcal/week) experienced fewer subsequent hospital admissions and fewer days in hospital than did sedentary individuals, after adjusting for covariates. Trends for reduced hospitalisation costs were also found. These associations persisted in sensitivity analyses, including tests of reverse causation. Conclusion this study has provided evidence that older adults who are at least moderately active may minimise utilisation of hospital care services. The findings highlight the importance of maintaining a physically active lifestyle in later life.
Collapse
Affiliation(s)
- Po-Wen Ku
- Graduate Institute of Sports and Health, National Changhua University of Education, Taiwan
| | - Andrew Steptoe
- Department of Epidemiology and Public Health, University College London, UK
| | - Yi-Huei Chen
- Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Li-Jung Chen
- Department of Epidemiology and Public Health, University College London, UK
- Department of Exercise Health Science, National Taiwan University of Sport, Taichung, Taiwan
| | - Ching-Heng Lin
- Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan
| |
Collapse
|
7
|
|
8
|
Bueno DR, Marucci MDFN, Codogno JS, Roediger MDA. [The costs of physical inactivity in the world: a general review]. CIENCIA & SAUDE COLETIVA 2016; 21:1001-10. [PMID: 27075999 DOI: 10.1590/1413-81232015214.09082015] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2015] [Accepted: 07/18/2015] [Indexed: 11/22/2022] Open
Abstract
There is convincing evidence in the scientific literature of the effectiveness of regular physical activity and physical exercise in the conservation of health and the prevention of various ailments. However, studies into the association between costs of medical services and physical inactivity have not been duly addressed. International studies have quantified these costs and revealed the association between physical activity and/or sedentary behavior. Therefore, this review sought to gather information available from several countries and analyze the global costs associated with physical inactivity over the past few decades. The results of twenty-four original and well-researched articles in nine countries, including Brazil, were analyzed. The results showed that physical inactivity, irrespective of the method of classification, is burdensome to the economy of health worldwide, and directly responsible for the high cost of medication, the incidence of hospitalization and the frequency of medical appointments. The costs of the group of the physically inactive population affected by chronic diseases feature among the major components of the total costs involved in public health.
Collapse
Affiliation(s)
| | | | - Jamile Sanches Codogno
- Faculdade de Ciências e Tecnologia de Presidente Prudente, Universidade Estadual Paulista Júlio de Mesquita Filho, São Paulo, SP, Brasil
| | | |
Collapse
|
9
|
Dixon BE, Whipple EC, Lajiness JM, Murray MD. Utilizing an integrated infrastructure for outcomes research: a systematic review. Health Info Libr J 2015; 33:7-32. [PMID: 26639793 DOI: 10.1111/hir.12127] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2014] [Accepted: 10/16/2015] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To explore the ability of an integrated health information infrastructure to support outcomes research. METHODS A systematic review of articles published from 1983 to 2012 by Regenstrief Institute investigators using data from an integrated electronic health record infrastructure involving multiple provider organisations was performed. Articles were independently assessed and classified by study design, disease and other metadata including bibliometrics. RESULTS A total of 190 articles were identified. Diseases included cognitive, (16) cardiovascular, (16) infectious, (15) chronic illness (14) and cancer (12). Publications grew steadily (26 in the first decade vs. 100 in the last) as did the number of investigators (from 15 in 1983 to 62 in 2012). The proportion of articles involving non-Regenstrief authors also expanded from 54% in the first decade to 72% in the last decade. During this period, the infrastructure grew from a single health system into a health information exchange network covering more than 6 million patients. Analysis of journal and article metrics reveals high impact for clinical trials and comparative effectiveness research studies that utilised data available in the integrated infrastructure. DISCUSSION Integrated information infrastructures support growth in high quality observational studies and diverse collaboration consistent with the goals for the learning health system. More recent publications demonstrate growing external collaborations facilitated by greater access to the infrastructure and improved opportunities to study broader disease and health outcomes. CONCLUSIONS Integrated information infrastructures can stimulate learning from electronic data captured during routine clinical care but require time and collaboration to reach full potential.
Collapse
Affiliation(s)
- Brian E Dixon
- Richard M. Fairbanks School of Public Health at IUPUI, Indianapolis, IN, USA.,Regenstrief Institute, Inc., Indianapolis, IN, USA.,Center for Health Information and Communication, Department of Veterans Affairs, Veterans Health Administration, Health Services Research and Development Service CIN 13-416, Richard L. Roudebush VA Medical Center, Indianapolis, IN, USA
| | - Elizabeth C Whipple
- Ruth Lilly Medical Library, Indiana University School of Medicine, Indianapolis, IN, USA
| | | | - Michael D Murray
- Regenstrief Institute and Purdue University, Indianapolis, IN, USA
| |
Collapse
|
10
|
Fisher KL, Harrison EL, Reeder BA, Sari N, Chad KE. Is Self-Reported Physical Activity Participation Associated with Lower Health Services Utilization among Older Adults? Cross-Sectional Evidence from the Canadian Community Health Survey. J Aging Res 2015; 2015:425354. [PMID: 26347491 PMCID: PMC4541001 DOI: 10.1155/2015/425354] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Accepted: 03/17/2015] [Indexed: 11/18/2022] Open
Abstract
Purpose. To examine relationships between leisure time physical activity (LTPA) and health services utilization (H) in a nationally representative sample of community-dwelling older adults. Methods. Cross-sectional data from 56,652 Canadian Community Health Survey respondents aged ≥ 50 years (48% M; 52% F; mean age 63.5 ± 10.2 years) were stratified into three age groups and analysed using multivariate generalized linear modeling techniques. Participants were classified according to PA level based on self-reported daily energy expenditure. Nonleisure PA (NLPA) was categorized into four levels ranging from mostly sitting to mostly lifting objects. Results. Active 50-65-year-old individuals were 27% less likely to report any GP consultations (ORadj = 0.73; P < 0.001) and had 8% fewer GP consultations annually (IRRadj = 0.92; P < 0.01) than their inactive peers. Active persons aged 65-79 years were 18% less likely than inactive respondents to have been hospitalized overnight in the previous year (ORadj = 0.82, P < 0.05). Higher levels of NLPA were significantly associated with lower levels of HSU, across all age groups. Conclusion. Nonleisure PA appeared to be a stronger predictor of all types of HSU, particularly in the two oldest age groups. Considering strategies that focus on reducing time spent in sedentary activities may have a positive impact on reducing the demand for health services.
Collapse
Affiliation(s)
- Koren L. Fisher
- Department of Kinesiology, California State University, Fullerton 800 N. State College Boulevard, Fullerton, CA 92831, USA
- Department of Kinesiology, University of Saskatchewan, 87 Campus Drive, Saskatoon, SK, Canada S7N 5B2
| | - Elizabeth L. Harrison
- School of Physical Therapy, University of Saskatchewan, 1121 College Drive, Saskatoon, SK, Canada S7N 0W3
| | - Bruce A. Reeder
- Department of Community Health and Epidemiology, University of Saskatchewan, Box 7, Health Science Building, 107 Wiggins Road, Saskatoon, SK, Canada S7N 5E5
| | - Nazmi Sari
- Department of Economics, University of Saskatchewan, Arts 815, 9 Campus Drive, Saskatoon, SK, Canada S7N 5A5
| | - Karen E. Chad
- Department of Kinesiology, University of Saskatchewan, 87 Campus Drive, Saskatoon, SK, Canada S7N 5B2
| |
Collapse
|
11
|
Blodgett J, Theou O, Kirkland S, Andreou P, Rockwood K. The association between sedentary behaviour, moderate-vigorous physical activity and frailty in NHANES cohorts. Maturitas 2014; 80:187-91. [PMID: 25542406 DOI: 10.1016/j.maturitas.2014.11.010] [Citation(s) in RCA: 131] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2014] [Revised: 11/12/2014] [Accepted: 11/17/2014] [Indexed: 10/24/2022]
Abstract
OBJECTIVES (1) To examine how sedentary behaviour and moderate-vigorous (MVPA) are each experienced during the day across different levels of frailty; (2) estimate and compare the extent to which high levels of sedentary behaviour and low levels of MVPA are associated with increased frailty and self-reported health, disability and healthcare utilization. METHODS Community dwelling adults aged 50+ from the National Health and Nutrition Examination Survey (2003-2004; 2005-2006). Frailty was measured with the frailty index and physical activity was measured using ActiGraph accelerometers. RESULTS On average, people engaged in about 8.5h of sedentary behaviour each day. The most frail individuals were more sedentary and less likely to meet weekly MVPA guidelines (9.57 h/day; 8.3%) than non-frail individuals (8.18 h/day; 1.1%; p<0.001). Frail individuals failed to demonstrate the patterns of the healthier individuals-higher levels of sedentary behaviour on Sundays and in the evenings and decreasing MVPA throughout the week. High sedentary behaviour and low MVPA were independently associated with higher levels of frailty, poor self-reported health, high ADL disability and higher healthcare usage. CONCLUSIONS Many people over the age of 50, and most of those who are frail, were highly sedentary with very few meeting the recommended weekly levels of MVPA. Sedentary behaviour and MVPA were independently associated with frailty and adverse health outcomes in middle to older aged adults. Future research should focus on a longitudinal study to determine the temporal relationship between sedentary behaviour and frailty.
Collapse
Affiliation(s)
- Joanna Blodgett
- Department of Community Health and Epidemiology, Dalhousie University, Centre for Clinical Research, 5790 University Avenue, Halifax, NS, Canada B3H 1V7
| | - Olga Theou
- Geriatric Medicine, Department of Medicine, Dalhousie University, Veterans' Memorial Building, 5955 Veterans' Memorial Lane, Halifax, NS, Canada.
| | - Susan Kirkland
- Department of Community Health and Epidemiology, Dalhousie University, Centre for Clinical Research, 5790 University Avenue, Halifax, NS, Canada B3H 1V7; Geriatric Medicine, Department of Medicine, Dalhousie University, Veterans' Memorial Building, 5955 Veterans' Memorial Lane, Halifax, NS, Canada
| | - Pantelis Andreou
- Department of Community Health and Epidemiology, Dalhousie University, Centre for Clinical Research, 5790 University Avenue, Halifax, NS, Canada B3H 1V7
| | - Kenneth Rockwood
- Geriatric Medicine, Department of Medicine, Dalhousie University, Veterans' Memorial Building, 5955 Veterans' Memorial Lane, Halifax, NS, Canada; Centre for Health Care of the Elderly, QEII Health Sciences Centre, Capital District Health Authority, Veterans' Memorial Building, 5955 Veterans' Memorial Lane, Halifax, NS, Canada
| |
Collapse
|
12
|
Simmonds B, Fox K, Davis M, Ku PW, Gray S, Hillsdon M, Sharp D, Stathi A, Thompson J, Coulson J, Trayers T. Objectively assessed physical activity and subsequent health service use of UK adults aged 70 and over: a four to five year follow up study. PLoS One 2014; 9:e97676. [PMID: 24866573 PMCID: PMC4035293 DOI: 10.1371/journal.pone.0097676] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2013] [Accepted: 04/23/2014] [Indexed: 01/30/2023] Open
Abstract
Objectives To examine the associations between volume and intensity of older peoples' physical activity, with their subsequent health service usage over the following four to five years. Study Design A prospective cohort design using baseline participant characteristics, objectively assessed physical activity and lower limb function provided by Project OPAL (Older People and Active Living). OPAL-PLUS provided data on numbers of primary care consultations, prescriptions, unplanned hospital admissions, and secondary care referrals, extracted from medical records for up to five years following the baseline OPAL data collection. Participants and Data Collection OPAL participants were a diverse sample of 240 older adults with a mean age of 78 years. They were recruited from 12 General Practitioner surgeries from low, middle, and high areas of deprivation in a city in the West of England. Primary care consultations, secondary care referrals, unplanned hospital admissions, number of prescriptions and new disease diagnoses were assessed for 213 (104 females) of the original 240 OPAL participants who had either consented to participate in OPAL-PLUS or already died during the follow-up period. Results In regression modelling, adjusted for socio-economic variables, existing disease, weight status, minutes of moderate-to-vigorous physical activity (MVPA) per day predicted subsequent numbers of prescriptions. Steps taken per day and MVPA also predicted unplanned hospital admissions, although the strength of the effect was reduced when further adjustment was made for lower limb function. Conclusions Community-based programs are needed which are successful in engaging older adults in their late 70s and 80s in more walking, MVPA and activity that helps them avoid loss of physical function. There is a potential for cost savings to health services through reduced reliance on prescriptions and fewer unplanned hospital admissions.
Collapse
Affiliation(s)
- Bethany Simmonds
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol, United Kingdom
| | - Kenneth Fox
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol, United Kingdom; School of Sport & Exercise Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Mark Davis
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol, United Kingdom
| | - Po-Wen Ku
- Graduate Institute of Sports and Health, National Changhua University of Education, Changhua City, Changua, Taiwan
| | - Selena Gray
- Department of Health and Applied Social Sciences, University of the West of England, Bristol, United Kingdom
| | - Melvyn Hillsdon
- Sport and Health Sciences, Exeter University, Exeter, United Kingdom
| | - Debbie Sharp
- The School of Social and Community Medicine, The University of Bristol, Bristol, United Kingdom
| | - Afroditi Stathi
- Department for Health, The University of Bath, Bath, United Kingdom
| | - Janice Thompson
- School of Sport & Exercise Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Joanna Coulson
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol, United Kingdom
| | - Tanya Trayers
- The School of Social and Community Medicine, The University of Bristol, Bristol, United Kingdom
| |
Collapse
|
13
|
Carlson M, Kuo A, Chou CP, Clark F. Relationship of Global Self-Evaluations of Activity to Psychosocial and Health-Related Aging Outcomes. OTJR-OCCUPATION PARTICIPATION AND HEALTH 2013. [DOI: 10.3928/15394492-20130712-01] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The authors obtained older adults' self-rated judgments about the quality of their activity engagement considered as a whole (global activity evaluation) and, using cross-sectional survey data, tested the ability of such judgments to predict well-being. Participants were 460 community-dwelling older adults who responded to (1) global activity evaluations, (2) activity participation frequency scales, and (3) indices of life satisfaction, depression, and physical and mental health-related quality of life. Regression analyses indicated that global activity evaluations had a stronger relationship to psychosocial outcome indices than did participation frequency ratings, although both measurement approaches were associated with statistically significant predictions. However, global evaluations and participation frequency ratings were approximately equal in their ability to predict physical health-related quality of life. These relationships were fairly consistent across ethnic groups. Overall, the results suggest that ideally the two strategies for assessing activity should be incorporated in future research on activity and occupational therapy practice.
Collapse
|
14
|
Kim J, Park S. [Impact of level of physical activity on healthcare utilization among Korean adults]. J Korean Acad Nurs 2012; 42:199-206. [PMID: 22699169 DOI: 10.4040/jkan.2012.42.2.199] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
PURPOSE This study was done to identify the impact of physical activity on healthcare utilization among Korean adults. METHODS Drawing from the 2008 Korean National Health and Nutrition Examination Survey (NHANES IV-2), data from 6,521 adults who completed the Health Interview and Health Behavior Surveys were analyzed. Association between physical activity and healthcare utilization was tested using the χ²-test. Multiple logistic regression analysis was used to calculate the odds ratios of using outpatient and inpatient healthcare for different levels of physical activity after adjusting for predisposing, enabling, and need factors. A generalized linear model applying a negative binomial distribution was used to determine how the level of physical activity was related to use of outpatient and inpatient healthcare. RESULTS Physically active participants were 16% less likely to use outpatient healthcare (OR, 0.84; 95% CI, 0.74-0.97) and 23% less likely to use inpatient healthcare (OR, 0.77; 95% CI, 0.63-0.93) than physically inactive participants. Levels of outpatient and inpatient healthcare use decreased as levels of physical activity increased, after adjusting for relevant factors. CONCLUSION An independent association between being physically active and lower healthcare utilization was ascertained among Korean adults indicating a need to develop nursing intervention programs that encourage regular physical activity.
Collapse
Affiliation(s)
- Jiyun Kim
- Department of Nursing, Gachon University, Seongnam, Korea
| | | |
Collapse
|
15
|
Sari N. Exercise, physical activity and healthcare utilization: A review of literature for older adults. Maturitas 2011; 70:285-9. [PMID: 21924847 DOI: 10.1016/j.maturitas.2011.08.004] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2011] [Accepted: 08/22/2011] [Indexed: 11/29/2022]
Abstract
The impacts of exercise and physical activity on healthcare utilization of older adults have been studied using either (1) clinical trials or retrospective cohort studies focusing on older people who participated in various exercise intervention programs, or (2) survey data. This review focuses on both streams of studies, which cover the topic for adults aged 65 and older. The paper reviews the literature on physical activity and its implications for healthcare system, and discusses potential directions for future research by highlighting the limitations of the existing studies. Although there are significant variations in samples and methods used, both streams of reviewed literature provide evidence that physical activity leads to lower utilization of healthcare services. Given differences in methods and samples in these studies, estimated effect of physical activity on healthcare utilization shows significant variation from one study to another. These results, therefore, cannot be generalized to justify population wide exercise intervention programs for older adults. Additional studies are needed to provide more robust estimates for the effects of exercise, and to examine the feasibility of population wide policies that aim to encourage participation of older adults in physical activity.
Collapse
Affiliation(s)
- Nazmi Sari
- University of Saskatchewan, Department of Economics & SPHERU, 9 Campus Drive, Saskatoon SK S7N 5A5, Canada.
| |
Collapse
|
16
|
Li CL, Chu SJ, Sheu JT, Huang LYG. Impact of physical activity on hospitalization in older adults: A nationwide cohort from Taiwan. Arch Gerontol Geriatr 2011; 53:141-5. [DOI: 10.1016/j.archger.2010.09.014] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2010] [Revised: 09/22/2010] [Accepted: 09/24/2010] [Indexed: 01/10/2023]
|
17
|
Nagai M, Kuriyama S, Kakizaki M, Ohmori-Matsuda K, Sone T, Hozawa A, Kawado M, Hashimoto S, Tsuji I. Impact of walking on life expectancy and lifetime medical expenditure: the Ohsaki Cohort Study. BMJ Open 2011; 1:e000240. [PMID: 22021866 PMCID: PMC3191604 DOI: 10.1136/bmjopen-2011-000240] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE People who spend a longer time walking have lower demands for medical care. However, in view of their longer life expectancy, it is unclear whether their lifetime medical expenditure increases or decreases. The present study examined the association between time spent walking, life expectancy and lifetime medical expenditure. METHOD The authors followed up 27,738 participants aged 40-79 years and prospectively collected data on their medical expenditure and survival covering a 13-year-period. Participants were classified into those walking <1 and ≥1 h per day. The authors constructed life tables and estimated the life expectancy and lifetime medical expenditure from 40 years of age using estimate of multiadjusted mortality and medical expenditure using a Poisson regression model and linear regression model, respectively. RESULTS Participants who walked ≥1 h per day have a longer life expectancy from 40 years of age than participants who walked <1 h per day. The multiadjusted life expectancy for those who walked ≥1 h per day was 44.81 years, significantly lower by 1.38 years in men (p=0.0073) in men and 57.78 years in women, non-significantly lower by 1.16 years in women (p=0.2351). In addition to their longer life expectancy, participants who walked ≥1 h per day required a lower lifetime medical expenditure from 40 years of age than participants who walked <1 h per day. The multiadjusted lifetime medical expenditure for those who walked ≥1 h per day was £99 423.6, significantly lower by 7.6% in men (p=0.0048) and £128 161.2, non-significantly lower by 2.7% in women (p=0.2559). DISCUSSION Increased longevity resulting from a healthier lifestyle does not necessarily translate into an increased amount of medical expenditure throughout life. Encouraging people to walk may extend life expectancy and decrease lifetime medical expenditure, especially for men.
Collapse
Affiliation(s)
- Masato Nagai
- Division of Epidemiology, Department of Public Health and Forensic Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.
| | | | | | | | | | | | | | | | | |
Collapse
|
18
|
Nguyen HQ, Maciejewski ML, Gao S, Lin E, Williams B, Logerfo JP. Health care use and costs associated with use of a health club membership benefit in older adults with diabetes. Diabetes Care 2008; 31:1562-7. [PMID: 18458143 PMCID: PMC2494648 DOI: 10.2337/dc08-0624] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE The purpose of this study was to determine whether elective use of a health plan-sponsored health club membership had an impact on health care use and costs among older adults with diabetes. RESEARCH DESIGN AND METHODS Administrative claims for 2,031 older adults with diabetes enrolled in a Medicare Advantage plan were obtained for this retrospective cohort study. Participants (n = 618) in the plan-sponsored health club benefit (Silver Sneakers [SS]) and control subjects (n = 1,413) matched on SS enrollment index date were enrolled in the plan for at least 1 year before the index date. Two-year health care use and costs of SS participants and control subjects were estimated in regressions adjusting for baseline differences. RESULTS SS participants were more likely to be male, had a lower chronic disease burden, used more preventive services, and had a lower prevalence of arthritis (P <or= 05). SS participants had lower adjusted total health care costs than control subjects in the first year after enrollment (-$1,633 [95% CI -$2,620 to -$646], P = 0.001), and adjusted total costs in year 2 trended lower (-$1,230 [-$2,494 to $33], P = 0.06). Participants who made on average >or=2 SS visits/week in year 1 had lower total costs in year 2 ($2,141 [-$3,877 to -$405], P = 0.02) than participants who made <2 visits/week. CONCLUSIONS Use of a health club benefit by older adults with diabetes was associated with slower growth in total health care costs over 2 years; greater use of the benefit was actually associated with declines in total costs.
Collapse
Affiliation(s)
- Huong Q Nguyen
- Department of Biobehavioral Nursing and Health Systems, University of Washington, Seattle, Washington, USA.
| | | | | | | | | | | |
Collapse
|
19
|
Ackermann RT, Williams B, Nguyen HQ, Berke EM, Maciejewski ML, LoGerfo JP. Healthcare cost differences with participation in a community-based group physical activity benefit for medicare managed care health plan members. J Am Geriatr Soc 2008; 56:1459-65. [PMID: 18637982 DOI: 10.1111/j.1532-5415.2008.01804.x] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To determine whether participation in a physical activity benefit by Medicare managed care enrollees is associated with lower healthcare utilization and costs. DESIGN Retrospective cohort study. SETTING Medicare managed care. PARTICIPANTS A cohort of 1,188 older adult health maintenance organization enrollees who participated at least once in the EnhanceFitness (EF) physical activity benefit and a matched group of enrollees who never used the program. MEASUREMENTS Healthcare costs and utilization were estimated. Ordinary least squares regression was used, adjusting for demographics, comorbidity, indicators of preventive service use, and baseline utilization or cost. Robustness of findings was tested in sensitivity analyses involving continuous propensity score adjustment and generalized linear models with nonconstant variance assumptions. RESULTS EF participants had similar total healthcare costs during Year 1 of the program, but during Year 2, adjusted total costs were $1,186 lower (P=.005) than for non-EF users. Differences were partially attributable to lower inpatient costs (-$3,384; P=.02), which did not result from high-cost outliers. Enrollees who attended EF an average of one visit or more per week had lower adjusted total healthcare costs in Year 1 (-$1,929; P<.001) and Year 2 (-$1,784; P<.001) than nonusers. CONCLUSION Health plan coverage of a preventive physical activity benefit for seniors is a promising strategy to avoid significant healthcare costs in the short term.
Collapse
Affiliation(s)
- Ronald T Ackermann
- Department of Medicine, School of Medicine, Indiana University, Indianapolis, Indiana 46202, USA.
| | | | | | | | | | | |
Collapse
|
20
|
Nguyen HQ, Ackermann RT, Berke EM, Cheadle A, Williams B, Lin E, Maciejewski ML, LoGerfo JP. Impact of a managed-Medicare physical activity benefit on health care utilization and costs in older adults with diabetes. Diabetes Care 2007; 30:43-8. [PMID: 17192331 DOI: 10.2337/dc06-1013] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE The purpose of this article was to determine the effects of a managed-Medicare physical activity benefit on health care utilization and costs among older adults with diabetes. RESEARCH DESIGN AND METHODS This retrospective cohort study used administrative and claims data for 527 patients from a diabetes registry of a staff model HMO. Participants (n = 163) were enrolled in the HMO for at least 1 year before joining the Enhanced Fitness Program (EFP), a community-based physical activity program for which the HMO pays for each EFP class attended. Control subjects were matched to participants according to the index date of EFP enrollment (n = 364). Multivariate regression models were used to determine 12-month postindex differences in health care use and costs between participants and control subjects while adjusting for age, sex, chronic disease burden, EFP attendance, prevention score, heart registry, and respective baseline use and costs. RESULTS Participants and control subjects were similar at baseline with respect to age (75 +/- 5.5 years), A1C levels (7.4 +/- 1.4%), chronic disease burden, prevention score, and health care use and costs. After exposure to the program, there was a trend toward lower hospital admissions in EFP participants compared with control subjects (13.5 vs. 20.9%, P = 0.08), whereas total health care costs were not different (P = 0.39). EFP participants who attended > or = 1 exercise session/week on average had approximately 41% less total health care costs compared with those attending <1 session/week (P = 0.03) and with control subjects (P = 0.02). CONCLUSIONS Although elective participation in a community-based physical activity benefit at any level was not associated with lower inpatient or total health care costs, greater participation in the program may lower health care costs. These findings warrant additional investigations to determine whether policies to offer and promote a community-based physical activity benefit in older adults with diabetes can reduce health care costs.
Collapse
Affiliation(s)
- Huong Q Nguyen
- Department of Behavioral Nursing and Health Systems, University of Washington, Seattle, WA 98199, USA.
| | | | | | | | | | | | | | | |
Collapse
|
21
|
Martin MY, Powell MP, Peel C, Zhu S, Allman R. Leisure-Time Physical Activity and Health-Care Utilization in Older Adults. J Aging Phys Act 2006; 14:392-410. [PMID: 17215558 DOI: 10.1123/japa.14.4.392] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
This study examined whether leisure-time physical activity (LTPA) was associated with health-care utilization in a racially diverse sample of rural and urban older adults. Community-dwelling adults (N= 1,000, 75.32 ± 6.72 years old) self-reported participating in LTPA and their use of the health-care system (physician visits, number and length of hospitalizations, and emergency-room visits). After controlling for variables associated with health and health-care utilization, older adults who reported lower levels of LTPA also reported a greater number of nights in the hospital in the preceding year. There was no support, however, for a relationship between LTPA and the other indicators of health-care utilization. Our findings suggest that being physically active might translate to a quicker recovery for older adults who are hospitalized. Being physically active might not only have health benefits for older persons but also lead to lower health-care costs.
Collapse
Affiliation(s)
- Michelle Y Martin
- Dept. of Medicine, the Birmingham/Atlanta VA Geriatric Research, Education and Clinical Center, University of Alabama at Birmingham, AL, USA
| | | | | | | | | |
Collapse
|
22
|
Castillo Garzón MJ, Ortega Porcel FB, Ruiz Ruiz J. Mejora de la forma física como terapia antienvejecimiento. Med Clin (Barc) 2005; 124:146-55. [PMID: 15713246 DOI: 10.1157/13071011] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Several recent important studies have clearly shown that a low physical fitness represents a potent risk factor and even a predictor of both cardiovascular and all-causes morbidity and mortality. As a consequence, physical fitness assessment should be performed at the clinical level since, when properly assessed, it is a highly valuable health and life expectancy indicator. Based on the results of fitness assessment in a particular person and knowing his/her life style and daily physical activity, an individually adapted training program can be prescribed. This training program will allow that person to develop his/her maximal physical potential while improving his/her physical and mental health and attenuating the deleterious consequences of aging. In fact, physical exercise is today proposed as a highly effective means to treat and prevent major morbidity and mortality causes in industrialized countries. Most of these causes are associated with the aging process. In order to be effective, this type of intervention should be directed to improve the aerobic capacity and strength. In addition, it should be complemented with work directed to improve the general coordination and flexibility. Finally, diet optimization and use of nutritional supplements and legal ergogenic aids are key elements to improve the functional capacity and health, all of which is synonymous of anti-aging interventions.
Collapse
Affiliation(s)
- Manuel J Castillo Garzón
- Grupo de Investigación en Evaluación Funcional y Fisiología del Ejercicio, Laboratorio de Fisiología del Ejercicio, Facultad de Medicina, Universidad de Granada, Granada, Spain.
| | | | | |
Collapse
|
23
|
Walkability and self-rated health in primary care patients. BMC FAMILY PRACTICE 2004; 5:29. [PMID: 15575954 PMCID: PMC539238 DOI: 10.1186/1471-2296-5-29] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/30/2004] [Accepted: 12/02/2004] [Indexed: 11/25/2022]
Abstract
Background The objective of this study was to investigate the relationship between perceived walkability and overall self-rated health among patients who use community-based clinics. Methods A cross-sectional survey was distributed to a convenience sample in three community clinics. Forms were completed by 793 clinic patients. Multiple logistic regression analysis was to control for the effects of demographic variables and lifestyles. Results Perceiving the availability of places to walk was related to better self-rated health. The most important places were work (OR = 3.2), community center (OR = 3.12), park (OR = 2.45) and day care (OR = 2.05). Respondents who said they had zero (OR = .27) or one (OR = .49) place to walk were significantly less healthy than persons who said they had five or more places to walk. Conclusion Persons who perceived that they had no place to walk were significantly less healthy than persons who thought they had at least one place to walk (OR = .39). Support for walkable neighborhoods and education of patients about options for walking may be in the best interests of community medicine patients.
Collapse
|
24
|
DataBase: Research and Evaluation Results. Am J Health Promot 2004. [DOI: 10.4278/0890-1171-18.5.398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
25
|
Clark DO, Stump TE, Damush TM. Outcomes of an exercise program for older women recruited through primary care. J Aging Health 2003; 15:567-85. [PMID: 12914021 DOI: 10.1177/0898264303253772] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES This study reports the social cognitive, health status, and health service use outcomes of an exercise intervention among women over 50 years of age. METHODS A random sample of patients was drawn from two primary care centers that serve a predominantly low-income and African American population. After provider screen, 412 women were eligible and invited to participate in the study. Of these, 123 participated and 1-year follow-up data are available for 72 participants. RESULTS Participants were more likely to be African American and had a higher average body weight than nonparticipants. Perceived health was the only variable that differed by adherence group at baseline. At 1 year, differences were apparent for body weight, body mass index, hip and waist circumference, triceps skinfold, and exercise self-esteem. The no-adherence group got worse, whereas the moderate adherence group improved. DISCUSSION These data suggest that even suboptimal adherence to moderate-intensity exercise can yield health benefits
Collapse
|
26
|
Pickering TG. In praise of walking: an antidote to increasing health care costs in the elderly? J Clin Hypertens (Greenwich) 2001; 3:380-2. [PMID: 11723361 PMCID: PMC8099236 DOI: 10.1111/j.1524-6175.2001.00676.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- T G Pickering
- Integrative and Behavioral Cardiovascular Health Program, Zena and Michael Wiener Cardiovascular Institute, Mt. Sinai School of Medicine, New York, NY 10029, USA
| |
Collapse
|