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Kikuti-Koyama KA, Lemes ÍR, Morais LCD, Monteiro HL, Turi-Lynch BC, Fernandes RA, Codogno JS. Combined association of insufficient physical activity and sleep problems with healthcare costs: a longitudinal study. SAO PAULO MED J 2024; 142:e2023241. [PMID: 38896745 DOI: 10.1590/1516-3180.2023.0241.r2.25032024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 03/25/2024] [Indexed: 06/21/2024] Open
Abstract
BACKGROUND The magnitude of economic losses attributed to sleep problems and insufficient physical activity (PA) remains unclear. This study aimed to investigate the association between insufficient PA, sleep problems, and direct healthcare costs. OBJECTIVE To investigate the association between insufficient physical activity (PA), sleep problems, and direct healthcare costs among adults. DESIGN AND SETTING Adults aged ≥ 50 years attended by the Brazilian National Health Service were tracked from 2010 to 2014. METHODS Direct healthcare costs were assessed using medical records and expressed in US$. Insufficient PA and sleep problems were assessed through face-to-face interviews. Differences were identified using the analysis of covariance and variance for repeated measures. RESULTS In total, 454 women and 166 men were enrolled. Sleep problems were reported by 28.9% (95%CI: 25.2% to 32.4%) of the sample, while insufficient PA was reported by 84.8% (95%CI: 82.1% to 87.6%). The combination of sleep problems and insufficient PA explained 2.3% of all healthcare costs spent on these patients from 2010 to 2014, which directly accounts for approximately US$ 4,765.01. CONCLUSION The combination of sleep problems and insufficient PA plays an important role in increasing direct healthcare costs in adults. Public health stakeholders, policymakers, and health professionals can use these results to reinforce the need for strategies to improve sleep quality and increase PA, especially in nations that finance their National Health Systems.
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Affiliation(s)
- Kelly Akemi Kikuti-Koyama
- Student, Department of Physical Education, Laboratory of InVestigation in Exercise (LIVE), Universidade Estadual Paulista (UNESP), Presidente Prudente (SP), Brazil
| | - Ítalo Ribeiro Lemes
- Assistant Professor, Physiotherapy Department, Universidade Estadual Paulista (UNESP), Presidente Prudente (SP), Brazil; Assistant Professor, Physiotherapy Department, Faculdade Israelita de Ciências da Saúde Albert Einstein (FICSAE), São Paulo (SP), Brazil
| | - Luana Carolina de Morais
- Student, Laboratory of InVestigation in Exercise (LIVE), Department of Physical Education, Universidade Estadual Paulista (UNESP), Presidente Prudente (SP), Brazil
| | - Henrique Luiz Monteiro
- Assistant Professor, Department of Physical Education, Universidade Estadual Paulista (UNESP), Bauru (SP), Brazil
| | - Bruna Camilo Turi-Lynch
- Assistant Professor, Physical Education and Exercise Science Department, Lander University, Greenwood, United States
| | - Rômulo Araújo Fernandes
- Associate Professor, Laboratory of InVestigation in Exercise - LIVE, Department of Physical Education, Universidade Estadual Paulista (UNESP), Presidente Prudente (SP), Brazil
| | - Jamile Sanches Codogno
- Assistant Professor, Laboratory of InVestigation in Exercise - LIVE, Department of Physical Education, Universidade Estadual Paulista (UNESP), Presidente Prudente (SP), Brazil
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Orbolato R, Fernandes RA, Turi-Lynch BC, Araujo MYC, Ferro IDS, Gobbo LA, Zanuto EAC, Codogno JS. Impact of cycling and walking on adiposity and healthcare costs among adults: longitudinal study. CAD SAUDE PUBLICA 2024; 40:e00102623. [PMID: 38422248 PMCID: PMC10896485 DOI: 10.1590/0102-311xen102623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 10/23/2023] [Accepted: 12/01/2023] [Indexed: 03/02/2024] Open
Abstract
Leisure-time physical activity seems relevant to prevent the development of chronic diseases and obesity. However, not much is known about the economic burden of these healthy behaviors, mainly in longitudinal designs. This study aimed to analyze the impact of walking and cycling on leisure-time on adiposity and healthcare costs among adults. This longitudinal study was conducted at a medium-size Brazilian city and included 198 participants with no missing data attended in the Brazilian Unified National Health System. Cycling and walking were assessed by a questionnaire with a face-to-face interview at four time-points (baseline, 6-month, 12-month, and 18-month). Healthcare costs were assessed using medical records. Adiposity markers included waist circumference and body fatness. Over the follow-up period, participants who were more engaged in cycling presented lower body fatness (p-value = 0.028) and healthcare costs (p-value = 0.038). However, in the multivariate model, the impact of cycling on costs was not significant (p-value = 0.507) due to the impact of number of chronic diseases (p-value = 0.001). Cycling on leisure-time is inversely related to adiposity in adults, whereas its role on preventing chronic diseases seems the main pathway linking it to cost mitigation.
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Affiliation(s)
- Rafael Orbolato
- Universidade Estadual Paulista Júlio de Mesquita Filho, Presidente Prudente, Brasil
| | | | - Bruna Camilo Turi-Lynch
- Universidade Estadual Paulista Júlio de Mesquita Filho, Presidente Prudente, Brasil
- Lander University, Greenwood, U. S. A
| | | | | | - Luis Alberto Gobbo
- Universidade Estadual Paulista Júlio de Mesquita Filho, Presidente Prudente, Brasil
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Erlangga D, Powell-Jackson T, Balabanova D, Hanson K. Determinants of government spending on primary healthcare: a global data analysis. BMJ Glob Health 2023; 8:e012562. [PMID: 38035736 PMCID: PMC10689394 DOI: 10.1136/bmjgh-2023-012562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 10/16/2023] [Indexed: 12/02/2023] Open
Abstract
In 2018 global leaders renewed their political commitment to primary healthcare (PHC) ratifying the Declaration of Astana emphasising the importance of building a sustainable PHC system based on accessible and affordable delivery models strengthened by community empowerment. Yet, PHC often remains underfunded, of poor quality, unreliable and not accountable to users which further deprives PHC of funding. This paper analyses the determinants of PHC expenditure in 102 countries, and quantitatively tests the influence of a set of economic, social and political determinants of government expenditure on PHC. The analysis is focused on the determinants of PHC funding from government sources as the government is in a position to make decisions in relation to this expenditure as opposed to out-of-pocket spending which is not in their direct control. Multivariate regression analysis was done to determine statistically significant predictors.Our analysis found that some economic factors-namely Gross Domestic Product (GDP) per capita, government commitment to health and tax revenue raising capacity-were strongly associated with per capita government spending on PHC. We also found that control of corruption was strongly associated with the level of total spending on PHC, while voice and accountability were positively associated with greater government commitment to PHC as measured by government spending on PHC as a share of total government health spending.Our analysis takes a step towards understanding of the drivers of PHC expenditure beyond the level of national income. Some of these drivers may be beyond the remit of health policy decision makers and relate to broader governance arrangements and political forces in societies. Thus, efforts to prioritise PHC in the health agenda and increase PHC expenditure should recognise the constraints within the political landscapes and engage with a wide range of actors who influence decisions affecting the health sector.
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Affiliation(s)
- Darius Erlangga
- Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, UK
| | - Timothy Powell-Jackson
- Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, UK
| | - Dina Balabanova
- Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, UK
| | - Kara Hanson
- Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, UK
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Araujo MYC, Kokubun E, Norberto MCCS, Bento ALS, Turi-Lynch BC, Codogno JS. Habitual physical activity minimizes healthcare costs resulting from comorbidities among adults with cardiovascular diseases. Braz J Phys Ther 2023; 27:100551. [PMID: 37827018 PMCID: PMC10582273 DOI: 10.1016/j.bjpt.2023.100551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 08/22/2023] [Accepted: 09/24/2023] [Indexed: 10/14/2023] Open
Abstract
BACKGROUND Habitual physical activity (HPA) can be used as a non-pharmacological strategy to prevent and control chronic diseases, as well as playing a role in minimizing healthcare costs. OBJECTIVE To verify the impact of HPA on healthcare costs at different levels of care, over 24 months, in an adult population with cardiovascular diseases (CVD), including individuals with or without comorbidities. METHODS Two-hundred and seventy-eight adults with CVD, aged between 30 and 65 years, participated in the study. Information on healthcare costs was obtained from medical records and included primary, secondary, and tertiary levels. Comorbidities such as diabetes, dyslipidemia, arterial hypertension, and obesity were registered. HPA was measured using the Baecke questionnaire. Comparisons between groups were performed using Student's t ( RESULTS The presence of comorbidities increased healthcare costs (p<0.05). HPA provided savings ranging from US$ 22.5/24 months to US$ 63.9/24 months with primary healthcare services, regardless of the presence of comorbidities. CONCLUSION Considering adults with CVD, HPA significantly minimizes healthcare costs in the primary care in Brazil, even in the presence of comorbidities, such as diabetes, dyslipidemia, arterial hypertension, and obesity.
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Affiliation(s)
- Monique Yndawe Castanho Araujo
- Post-graduation Program in Movement Sciences, Universidade Estadual Paulista (UNESP), Presidente Prudente, São Paulo, Brazil; Group of Studies in Health, Physical Activity, and Economy (GESAFE), Universidade Estadual Paulista (UNESP), Presidente Prudente, São Paulo, Brazil.
| | - Eduardo Kokubun
- Post-graduation Program in Movement Sciences, Universidade Estadual Paulista (UNESP), Rio Claro, São Paulo, Brazil
| | - Maria Carolina Castanho Saes Norberto
- Post-graduation Program in Movement Sciences, Universidade Estadual Paulista (UNESP), Presidente Prudente, São Paulo, Brazil; Group of Studies in Health, Physical Activity, and Economy (GESAFE), Universidade Estadual Paulista (UNESP), Presidente Prudente, São Paulo, Brazil
| | - André Lucas Servo Bento
- Group of Studies in Health, Physical Activity, and Economy (GESAFE), Universidade Estadual Paulista (UNESP), Presidente Prudente, São Paulo, Brazil
| | - Bruna Camilo Turi-Lynch
- Department of Physical Education and Exercise Science, Lander University, Greenwood, South Carolina, USA
| | - Jamile Sanches Codogno
- Post-graduation Program in Movement Sciences, Universidade Estadual Paulista (UNESP), Presidente Prudente, São Paulo, Brazil; Group of Studies in Health, Physical Activity, and Economy (GESAFE), Universidade Estadual Paulista (UNESP), Presidente Prudente, São Paulo, Brazil
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Lima Dos Santos L, Codogno JS, Camilo Turi-Lynch B, Araujo MYC, Fernandes RA, de Oliveira Gomes GA, Crankson S, Anokye N. Interrelationship between arterial hypertension, health service costs, therapeutic treatment and physical activity. BMC PRIMARY CARE 2023; 24:164. [PMID: 37626283 PMCID: PMC10463294 DOI: 10.1186/s12875-023-02120-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 07/31/2023] [Indexed: 08/27/2023]
Abstract
BACKGROUND Arterial hypertension is a high prevalence disease that increase healthcare costs and affects physical activity level. This study aimed to analyse the interrelationship between arterial hypertension, health service costs, therapeutic treatment, and physical activity in patients with cardiovascular diseases. METHOD Cross-sectional study that evaluated 306 patients from a hospital in Presidente Prudente-Brazil. Based on their medical diagnosis, they were classified into multiple groups to access primary care and hospital-related costs variations. Then, using data from medical records and face to face interviews, they were examined on their treatment adherence and physical activity practice. Healthcare costs were accessed using medical records. Finally, the generalised linear model was used to analyse the interrelationship between treatment adherence, physical activity, health care costs and arterial hypertension. The data were analysed with Stata/MP4 16, and a p-value of less than 5% was used to determine statistical significance. RESULTS The group that adhered to the arterial hypertension treatments but were physically inactive presented higher costs with consultation (US$=24.1, 95%CI = 1.90;46,3) medication (US$=56.60, 95%CI = 1.65; 111.5) and total primary health care costs (US$=71.60, 95%CI = 19.2; 123.9) even after adjusting for confounding variables, meanwhile those participants that adhered to the treatments and were physical active did not present difference in healthcare cost when compared to normotensive and physical active participants. CONCLUSION To be adherent to hypertension treatment were related to higher health care costs meanwhile been physical activity were related to lower health care costs and the combination of both showed that be adherent and physical activity represent the same cost with health than those normotensive and active emphasizing the importance of adherence and physical activity in the hypertensive treatment.
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Affiliation(s)
- Lionai Lima Dos Santos
- Department of Physical Education, São Paulo State University - UNESP, Presidente Prudente, São Paulo, Brazil
| | - Jamile Sanches Codogno
- Department of Physical Education, São Paulo State University - UNESP, Presidente Prudente, São Paulo, Brazil
| | - Bruna Camilo Turi-Lynch
- Department of Physical Education and Exercise Science, Lander University, 320 Stanley Avenue, 29649, Greenwood, SC, USA
| | | | - Romulo Araujo Fernandes
- Department of Physical Education, São Paulo State University - UNESP, Presidente Prudente, São Paulo, Brazil
| | | | - Shirley Crankson
- Department of Clinical Sciences, College of Health and Life Sciences, Brunel University London, London, UK
| | - Nana Anokye
- Department of Clinical Sciences, College of Health and Life Sciences, Brunel University London, London, UK.
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Productivity Loss, Healthcare Costs, and Habitual Physical Activity Among Adults With Cardiovascular Diseases. J Occup Environ Med 2022; 64:1001-1006. [PMID: 35941744 DOI: 10.1097/jom.0000000000002664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVES The aims of the study are to quantify the relationship between productivity loss and healthcare costs among adults with cardiovascular diseases and also to verify whether habitual physical activity (HPA) modulates this relationship. METHODS Information was obtained about healthcare costs, productivity loss, and HPA. RESULTS The sample consisted of 278 adults. Active workers who reported presenteeism and absenteeism due to cardiovascular diseases had higher direct costs ( P < 0.05) than those who reported other reasons. Those who reported absenteeism spent US $187.33 more on healthcare services annually than those who did not miss work because of health reasons. However, an annual savings of US $53.00 was observed for each increase in the score of HPA. CONCLUSIONS There was a positive correlation between absenteeism and direct healthcare costs among adults with cardiovascular diseases, and HPA positively affected this relationship.
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Turri JAO, Anokye NK, Dos Santos LL, Júnior JMS, Baracat EC, Santo MA, Sarti FM. Impacts of bariatric surgery in health outcomes and health care costs in Brazil: Interrupted time series analysis of multi-panel data. BMC Health Serv Res 2022; 22:41. [PMID: 34996426 PMCID: PMC8740498 DOI: 10.1186/s12913-021-07432-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 10/18/2021] [Indexed: 12/12/2022] Open
Abstract
Background The increasing burden of obesity generates significant socioeconomic impacts for individuals, populations, and national health systems worldwide. The literature on impacts and cost-effectiveness of obesity-related interventions for prevention and treatment of moderate to severe obesity indicate that bariatric surgery presents high costs associated with high effectiveness in improving health status referring to certain outcomes; however, there is a lack of robust evidence at an individual-level estimation of its impacts on multiple health outcomes related to obesity comorbidities. Methods The study encompasses a single-centre retrospective longitudinal analysis of patient-level data using micro-costing technique to estimate direct health care costs with cost-effectiveness for multiple health outcomes pre-and post-bariatric surgery. Data from 114 patients who had bariatric surgery at the Hospital of Clinics of the University of Sao Paulo during 2018 were investigated through interrupted time-series analysis with generalised estimating equations and marginal effects, including information on patients' characteristics, lifestyle, anthropometric measures, hemodynamic measures, biochemical exams, and utilisation of health care resources during screening (180 days before) and follow-up (180 days after) of bariatric surgery. Results The preliminary statistical analysis showed that health outcomes presented improvement, except cholesterol and VLDL, and overall direct health care costs increased after the intervention. However, interrupted time series analysis showed that the rise in health care costs is attributable to the high cost of bariatric surgery, followed by a statistically significant decrease in post-intervention health care costs. Changes in health outcomes were also statistically significant in general, except in cholesterol and LDL, leading to significant improvements in patients' health status after the intervention. Conclusions Trends multiple health outcomes showed statistically significant improvements in patients' health status post-intervention compared to trends pre-intervention, resulting in reduced direct health care costs and the burden of obesity.
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Affiliation(s)
- José Antonio Orellana Turri
- Department of Gynecology and Obstetrics, Central Institute of the Hospital of Clinics at the School of Medicine, University of Sao Paulo, R Dr Eneas de Carvalho Aguiar 255, Sao Paulo, SP, Brazil. .,School of Public Health, University of Sao Paulo, Av Dr Arnaldo 715, Sao Paulo, SP, Brazil.
| | - Nana Kwame Anokye
- Department of Clinical Sciences, College of Health and Life Sciences, Brunel University London, Kingston Lane, Uxbridge, United Kingdom
| | - Lionai Lima Dos Santos
- Department of Physiotherapy, School of Sciences and Technology, Sao Paulo State University, Rua Roberto Simonsen, Presidente Prudente, SP, 305, Brazil
| | - José Maria Soares Júnior
- Department of Gynecology and Obstetrics, Central Institute of the Hospital of Clinics at the School of Medicine, University of Sao Paulo, R Dr Eneas de Carvalho Aguiar 255, Sao Paulo, SP, Brazil
| | - Edmund Chada Baracat
- Department of Gynecology and Obstetrics, Central Institute of the Hospital of Clinics at the School of Medicine, University of Sao Paulo, R Dr Eneas de Carvalho Aguiar 255, Sao Paulo, SP, Brazil
| | - Marco Aurélio Santo
- Department of Gastroenterology, Digestive Disease Surgery, Central Institute of the Hospital of Clinics at the School of Medicine, University of Sao Paulo, R Dr Eneas de Carvalho Aguiar 255, Sao Paulo, SP, Brazil
| | - Flavia Mori Sarti
- School of Public Health, University of Sao Paulo, Av Dr Arnaldo 715, Sao Paulo, SP, Brazil.,School of Arts, Sciences and Humanities, University of Sao Paulo, Av Arlindo Bettio 1000, Sao Paulo, SP, Brazil
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Abstract
BACKGROUND Promotion of physical activity (PA) among populations is a global health investment. However, evidence on economic aspects of PA is sparse and scattered in low-income and middle-income countries (LMICs). OBJECTIVE The objective of this study was to summarise the available evidence on economics of PA in LMICs, identify potential target variables for policy and report gaps in the existing economic evidence alongside research recommendations. DATA SOURCES A systematic review of the electronic databases (Scopus, Web of Science and SPORTDiscus) and grey literature. STUDY ELIGIBILITY CRITERIA Cost-of-illness studies, economic evaluations, interventions and descriptive studies on economic factors associated with PA using preset eligibility criteria. STUDY APPRAISAL AND SYNTHESIS OF METHODS Screening, study selection and quality appraisal based on standard checklists performed by two reviewers with consensus of a third reviewer. Descriptive synthesis of data was performed. RESULTS The majority of the studies were from upper-middle-income countries (n=16, 88.8%) and mainly from Brazil (n=9, 50%). Only one economic evaluation study was found. The focus of the reviewed literature spanned the economic burden of physical inactivity (n=4, 22%), relationship between PA and costs (n=6, 46%) and socioeconomic determinants of PA (n=7, 39%). The findings showed a considerable economic burden due to insufficient PA, with LMICs accounting for 75% of disability-adjusted life years (DALYs) globally due to insufficient PA. Socioeconomic correlates of PA were identified, and inverse relationship of PA with the cost of chronic diseases was established. Regular PA along with drug treatment as a treatment scheme for chronic diseases showed advantages with a cost-utility ratio of US$3.21/quality-adjusted life year (QALY) compared with the drug treatment-only group (US$3.92/QALY) by the only economic evaluation conducted in the LMIC, Brazil. LIMITATIONS Meta-analysis was not performed due to heterogeneity of the studies. CONCLUSIONS AND RECOMMENDATIONS Economic evaluation studies for PA promotion interventions/strategies and local research from low-income countries are grossly inadequate. Setting economic research agenda in LMICs ought to be prioritised in those areas. PROSPERO REGISTRATION NUMBER CRD42018099856.
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Affiliation(s)
- Priyanga Diloshini Ranasinghe
- Health Economics Research Group, Division of Global Public Health, Department of Health Sciences, Brunel University London, UB8 3PH, UK
- Ministry of Health, Nutrition, Indegenous Medicine, Colombo 10, Sri Lanka
| | - Subhash Pokhrel
- Health Economics Research Group, Division of Global Public Health, Department of Health Sciences, Brunel University London, UB8 3PH, UK
| | - Nana Kwame Anokye
- Health Economics Research Group, Division of Global Public Health, Department of Health Sciences, Brunel University London, UB8 3PH, UK
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Lynch KR, Anokye NK, Vlachopoulos D, Barbieri FA, Turi-Lynch BC, Codogno JS, Agostinete RR, Fernandes RA. Impact of sports participation on incidence of bone traumatic fractures and health-care costs among adolescents: ABCD - Growth Study. PHYSICIAN SPORTSMED 2020; 48:298-303. [PMID: 31662014 DOI: 10.1080/00913847.2019.1685859] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Objective: To analyze the risk of bone traumatic fractures according to the engagement in sports, as well as to identify the potential impact of sports participation and traumatic fractures on health-care costs among adolescents. Methods: This is a longitudinal 12-month study of 285 adolescents of both sexes in Brazil. We assessed the occurrence of traumatic fractures and health-care services (hospitalizations, medicine use, medical consultations, and exams) by phone contact every month for 12 months. Adolescents were divided into four groups according to sport characteristics: non-sport (n = 104), non-impact sport (swimming [n = 34]), martial arts (n = 49 [judo, karate, kung-Fu]) and impact sports (n = 98 [track-and-field, basketball, gymnastics, tennis, and baseball]). Results: The incidence of new fractures was 2.1%. The overall costs accounted during the 12-month follow-up were U$ 3,259.66. Swimmers (US$ 13.86) had higher health-care costs than non-sport (US$ 1.82), martial arts (US$ 2.23), and impact sports (US$ 2.32). Conclusion: swimming seems to be related to higher health-care costs among adolescents.
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Affiliation(s)
- Kyle R Lynch
- Post-Graduation Program in Movement Science. Department of Physical Education, Sao Paulo State University - UNESP , Presidente Prudente, State of Sao Paulo, Brazil
| | - Nana K Anokye
- Institute of Environment, Health and Societies, Brunel University , London, UK
| | - Dimitris Vlachopoulos
- Children's Health and Exercise Research Centre, Sport and Health Sciences, University of Exeter , Exeter, UK
| | - Fabio A Barbieri
- Department of Physical Education, São Paulo State University (UNESP) - Campus Bauru, Human Movement Research Laboratory (MOVI-LAB) , Bauru, Brazil
| | - Bruna C Turi-Lynch
- Laboratory of InVestigation in Exercise - LIVE. Department of Physical Education, Sao Paulo State University - UNESP , Presidente Prudente, State of Sao Paulo, Brazil
| | - Jamile S Codogno
- Post-Graduation Program in Movement Science. Department of Physical Education, Sao Paulo State University - UNESP , Presidente Prudente, State of Sao Paulo, Brazil.,Laboratory of InVestigation in Exercise - LIVE. Department of Physical Education, Sao Paulo State University - UNESP , Presidente Prudente, State of Sao Paulo, Brazil
| | - Ricardo R Agostinete
- Post-Graduation Program in Movement Science. Department of Physical Education, Sao Paulo State University - UNESP , Presidente Prudente, State of Sao Paulo, Brazil.,Laboratory of InVestigation in Exercise - LIVE. Department of Physical Education, Sao Paulo State University - UNESP , Presidente Prudente, State of Sao Paulo, Brazil
| | - Romulo A Fernandes
- Post-Graduation Program in Movement Science. Department of Physical Education, Sao Paulo State University - UNESP , Presidente Prudente, State of Sao Paulo, Brazil.,Laboratory of InVestigation in Exercise - LIVE. Department of Physical Education, Sao Paulo State University - UNESP , Presidente Prudente, State of Sao Paulo, Brazil
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Nishijima M, Sarti FM, Schor A. Results of primary health care intervention for prevention of hospitalizations and mortality due to hypertension in Brazil, 2000–2015. J Public Health (Oxf) 2020. [DOI: 10.1007/s10389-019-01020-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Metabolic Syndrome, Physical Activity, and Medication-Related Expenditures: A Longitudinal Analysis. J Phys Act Health 2019; 16:830-835. [DOI: 10.1123/jpah.2018-0609] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Revised: 04/16/2019] [Accepted: 06/03/2019] [Indexed: 11/18/2022]
Abstract
Background: Metabolic syndrome (MetS) is a combination of risk factors for cardiovascular disease and type 2 diabetes mellitus. The prevalence of MetS worldwide is increasing. There is no study investigating the economic burden of MetS, especially in developing countries, on medication-related expenditure. The aim of this study was to investigate the association of medication-related expenditures with MetS and to explore how physical activity (PA) may influence this association. Methods: A total of 620 participants, 50 years or older, randomly selected in the city of Bauru, Brazil. Participants were followed from 2010 to 2014, and data on health care expenditure were collected annually. PA questionnaire was applied at baseline, 2 (2012), and 4 (2014) years later. Results: Mean age was 64.7 (95% confidence interval, 64.1–65.3). MetS was associated with higher medication expenditure related to diseases of the circulatory (P <.01) and endocrine (P <.01) systems. MetS explained 17.2% of medication-related expenditures, whereas PA slightly attenuated this association, explaining 1.1% of all health care costs. Conclusion: This study demonstrates that MetS has a significant burden on health care expenditures among adults, whereas PA seems to affect this phenomenon significantly, but in low magnitude.
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