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Zhang X, Zhang Y, Guo B, Chen G, Zhang R, Jing Q, Khan HT, Zhang L. The impact of physical activity on household out-of-pocket medical expenditure among adults aged 45 and over in urban China: The mediating role of spousal health behaviour. SSM Popul Health 2024; 25:101643. [PMID: 38449524 PMCID: PMC10915402 DOI: 10.1016/j.ssmph.2024.101643] [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: 01/15/2024] [Revised: 02/17/2024] [Accepted: 02/21/2024] [Indexed: 03/08/2024] Open
Abstract
Background Increasing medical expenditure is viewed as one of the critical challenges in the context of population ageing. Physical activity (PA), as a primary prevention strategy for promoting health, is considered as an effective way to curb the excessive growth in medical expenditure. This study aimed to analyze the association between PA and the household out-of-pocket medical expenditure (HOPME) among Chinese urban adults aged 45 and over, and to explore the mediating role of spousal health behaviour. Methods This study analyzed a nationally longitudinal survey: 2014-2018 China Family Panel Studies (CFPS). Fixed effects regression model was applied to estimate the association between PA and annual HOPME. Sobel model was utilized to test the mediating effect. Results (1) PA was negatively associated with the annual HOPME among urban resident aged 45 and over in China. Exercising 1-5 times per week and maintaining the duration of each exercise session at 31-60 min were effective in reducing annual HOPME. (2) Spousal PA played a significant mediating role in the relationship between respondent's PA and annual HOPME. (3) The negative association between the respondent's PA and HOPME were found among women and those aged between 45 and 65, so was the mediating effect of spouse's PA. Conclusion Individual PA not only directly reduces HOPME but also indirectly contributes to this reduction by enhancing the PA levels of their spouses. To capitalize on these benefits, more actions should be taken to increase the availability of PA facilities, enhance the public awareness of PA's benefits, and encourage residents to consistently engage in regular PA.
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Affiliation(s)
- Xiaodong Zhang
- Institute of Population Research, Peking University, Beijing, 100871, China
- The Oxford Institute of Population Ageing, University of Oxford, OX2 6PR, United Kingdom
| | - Yanan Zhang
- The Oxford Institute of Population Ageing, University of Oxford, OX2 6PR, United Kingdom
| | - Bin Guo
- Institute of Population Research, Peking University, Beijing, 100871, China
- National Sports Industry Research Base, Peking University, Beijing, 100871, China
| | - Gong Chen
- Institute of Population Research, Peking University, Beijing, 100871, China
| | - Rui Zhang
- National Sports Industry Research Base, Peking University, Beijing, 100871, China
| | - Qi Jing
- The Oxford Institute of Population Ageing, University of Oxford, OX2 6PR, United Kingdom
- School of Management, Shandong Second Medical University, Weifang, 261053, China
| | - Hafiz T.A. Khan
- The Oxford Institute of Population Ageing, University of Oxford, OX2 6PR, United Kingdom
- College of Nursing, Midwifery and Healthcare, University of West London, TW8 9GB, United Kingdom
| | - Lei Zhang
- Institute of Population Research, Peking University, Beijing, 100871, China
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Chen L, Xu X. Relationships between the Physical Activity Intensity and the Medical Expenditure of Middle-Aged and Elderly People: Parsing from the CHARLS Database. Behav Sci (Basel) 2023; 13:566. [PMID: 37504013 PMCID: PMC10376150 DOI: 10.3390/bs13070566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 06/24/2023] [Accepted: 07/03/2023] [Indexed: 07/29/2023] Open
Abstract
There are many studies on the impact of physical activity on health but few studies on the relationship between physical activity and medical expenditure among the elderly. Based on the China Health and Retirement Longitudinal Survey (CHARLS) database and selected 4456 valid samples, this paper used a two-part model to analyze the effects of high, moderate, and low physical activity intensity on medical expenditure. It is found that the intensity of physical activity was negatively correlated with medical expenditure, and the medical expenditure of the high physical activity intensity group was significantly lower than that of the low physical activity intensity group. For example, compared to people with no physical activity, the total medical expenditure decreased by 22.4%, 40.4%, and 62.5% per week in those with low, moderate, and high physical activity intensity. Thus, the government should provide more places for the elderly to exercise, planning special exercise areas for the elderly in community playgrounds, such as a dancing square, which will also help the elderly to increase their amount of exercise per week and develop a daily exercise habit.
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Affiliation(s)
- Linhong Chen
- School of Marxism, Chongqing Technology and Business University, Chongqing 400067, China
| | - Xiaocang Xu
- School of Economics and Management, Huzhou University, Huzhou 313000, China
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Reynolds AN, Moodie I, Venn B, Mann J. How do we support walking prescriptions for type 2 diabetes management? Facilitators and barriers following a 3-month prescription. J Prim Health Care 2021; 12:173-180. [PMID: 32594985 DOI: 10.1071/hc20023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Accepted: 05/26/2020] [Indexed: 01/15/2023] Open
Abstract
INTRODUCTION Prescribing physical activity is an inexpensive method to promote patients' long-term health, but determinants of adherence with physical activity prescriptions are seldom considered. AIM To identify facilitators and barriers experienced by adults with type 2 diabetes when prescribed regular walking. METHODS Participants were prescribed a regular walking routine that met current physical activity guidelines for type 2 diabetes management for a period of 3 months. Pre- and post-intervention questions considered participants' self-rated health and physical activity amount. Thematic analysis of recorded interviews held after the 3-month prescription identified barriers and facilitators to adherence for participants. RESULTS Twenty-eight adults (aged 60±9 years, body mass index 32.3±4.0kg/m2, HbA1c 59±16mmol/mol) participated in the 3-month intervention, providing 7 years of lived experience. Self-rated health (14%; 95% confidence interval (CI) 7-22%) and time spent walking (+11 min/day; 95% CI 4-18 min/day) increased following the prescription. Major themes motivating participants were: establishing a walking routine; the support of their family members; observing health benefits; and being monitored by a health professional. The greatest barriers were associated with walking in the evening and included feelings of insecurity in the dark or a preference for sedentary behaviour. DISCUSSION A prescription to walk increased time spent in physical activity and self-rated health in adults with type 2 diabetes. Health-care professionals can support walking prescriptions by promoting facilitators and reducing barriers to prescription adherence. Practical solutions to barriers include identifying alternative physical activity opportunities within the house or advice to develop support networks to provide company while walking.
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Affiliation(s)
- Andrew N Reynolds
- Department of Medicine, University of Otago, Dunedin, New Zealand; and Department of Human Nutrition, University of Otago, Dunedin, New Zealand; and Edgar Diabetes and Obesity Research Centre, University of Otago, Dunedin, New Zealand; and Corresponding author.
| | - Ian Moodie
- Department of English Education, Mokpo National University, Muan, South Korea
| | - Bernard Venn
- Department of Human Nutrition, University of Otago, Dunedin, New Zealand
| | - Jim Mann
- Department of Medicine, University of Otago, Dunedin, New Zealand; and Department of Human Nutrition, University of Otago, Dunedin, New Zealand; and Edgar Diabetes and Obesity Research Centre, University of Otago, Dunedin, New Zealand
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Lee BK. Comparison of Prevalence of Hyperlipidemia, Medical Expenses, Inpatient, Emergency and Outpatient According to the Level of Physical Activity of Korean Adults: A Cross-Sectional Study of 2018 Korea Medical Panel. THE ASIAN JOURNAL OF KINESIOLOGY 2021. [DOI: 10.15758/ajk.2021.23.1.34] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES The purpose of this study is to compare the difference in the prevalence of hyperlipidemia according to the level of physical activity in adults, and to compare the difference between annual personal medical expenses, hospitalization, emergency and outpatient use depending on the level of physical activity for hyperlipidemia patients.METHODS The 2018 Korea medical panel data was used (14,489 adults and 2,559 Hyperlipidemia). Physical activity was measured with short form of IPAQ and converted to MET-minutes per week. The days of hospitalization, and personal medical expenses were compared, and frequency analysis, logistic regression, ANOVA and chi-square were performed.RESULTS The prevalence of hyperlipidemia based on the inactive group were decreased both minimally active group (OR = 0.94) and the active group (OR = 0.74, p<0.01). Annual personal medical expenses I (p<.01) and II (p<.01) with hyperlipidemia were all showed significant differences depending on the level of physical activity. On active group basis, medical expenses showed slight differences of 3.0 to 3.2% with the minimally activity group, but that of the inactive group were 19.3 ~ 21.7% higher. The annual days of hospitalization were 6.8 ± 7.2 days in activity group, minimally activity group 7.1 ± 7.2 days, inactive group 11.7 ± 26.0 days. There was no significant difference in the annual days of hospitalization and emergency between the three groups. In particular, the annual days of outpatient increased sharply at the inactive group. Participation in physical activity has been shown to have a significant effect on hospitalization and decreasing use of emergency rooms.CONCLUSIONS Hyperlipidemia prevalence was similar to inactive groups and minimally activity groups, and that of activity groups was 0.74. On medical expenses of hyperlipidemia, the activity and minimally activity group was similar, the inactivity group was 19.3 to 21.7% higher. Physical activity was found to have a positive effect on hospitalization and emergency use reduction.
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Benioudakis ES, Georgiou ED, Barouxi ED, Armagos AM, Koutsoumani V, Anastasiou-Veneti F, Koutsoumani E, Brokalaki M. The diabetes quality of life brief clinical inventory in combination with the management strategies in type 1 diabetes mellitus with or without the use of insulin pump. Diabetol Int 2020; 12:217-228. [PMID: 33786276 DOI: 10.1007/s13340-020-00477-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 10/30/2020] [Indexed: 10/23/2022]
Abstract
Aims The aims of this study are to evaluate any differences in the Quality of life among Continuous Subcutaneous Insulin Infusion (CSII) and Multiple Dose Injection (MDI) insulin delivery, applying the Diabetes Quality of life Brief Clinical Inventory (DQoL-BCI) questionnaire, and assess the diabetes management strategies between the two groups. Methods One hundred and ten adult participants (male/female ratio 1:2.7) with type 1 diabetes were recruited in this online survey. Forty-eight of them were using CSII and the rest 62 (were using) MDI insulin delivery. A 23-item socio-demographic/diabetes management strategies questionnaire and the 15-item DQoL-BCI were administered. Results CSII users scored statistically, significantly better at the satisfaction treatment subscale (p = 0.032) of the DQoL-BCI and emerged that they were implemented more management strategies such as dietician guidance services (p = 0.002), carbohydrate education seminars (p = 0.03). Predictive factors were also detected regarding the HbA1c < 7% (53 mmol/mol) and β-coefficients in relation to DQoL-BCI questionnaire with the subscales of a negative impact and satisfaction treatment. Conclusion Diabetes self-management education plays a key role to a better compliance with the treatment. Client-centered multidisciplinary centers in T1DM education are essential so that they be applicable for all T1DM patients irrespective of the type of insulin delivery they used.
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Affiliation(s)
- Emmanouil S Benioudakis
- Department of Psychology, University of Crete, Rethimno, Greece.,Psychiatric Clinic, General Hospital of Chania, Chania, Greece
| | - Evangelos D Georgiou
- Statistical Methods in Medicine and Pharmacy, Athens University of Economics and Business, Athens, Greece.,Department of Psychology, University of Cyprus Centre for Field Studies, University of Cyprus, Nicosia, Cyprus
| | | | - Athanasios M Armagos
- Health Psychology, University of Crete, Rethimno, Greece.,Psychiatric Clinic, Naval Hospital of Athens (NNA), Athens, Greece
| | | | | | | | - Maria Brokalaki
- Nutrition and Dietetics, Technological Educational Institute of Crete, Sitia, Greece
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Zhao Y, Shen F, Gong M, Jin L, Ren X, Liu K, Lu J. Lifelong treadmill training improves muscle function detected by a modified grip strength test during aging in BALB/c mice. Life Sci 2020; 251:117603. [DOI: 10.1016/j.lfs.2020.117603] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 03/15/2020] [Accepted: 03/24/2020] [Indexed: 12/31/2022]
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Lee BK. Comparison of Prevalence of Diabetes Mellitus, Medical Expenses, Inpatient, Emergency and Outpatient According to the Level of Physical Activity of Korean Adults: A Cross-Sectional Study. THE ASIAN JOURNAL OF KINESIOLOGY 2019. [DOI: 10.15758/ajk.2019.21.3.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
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