Stearns S C, Bernard S L, Fasick S B, Schwartz R, Konrad T R, Ory M G, DeFriese G H
Department of Health Policy and Administration, University of North Carolina at Chapel Hill, 27599-7400, USA.
Am J Public Health. 2000 Oct;90(10):1608-12. doi: 10.2105/ajph.90.10.1608.
Self-care includes actions taken by individuals to promote or ensure their health, to recover from diseases or injuries, or to manage their effects. This study measured associations between self-care practices (lifestyle practices, adaptations to functional limitations, and medical self-care) and Medicare expenditures among a national sample of adults 65 years and older.
Regression models of Medicare use and expenditures were estimated by using the National Survey of Self-Care and Aging and Medicare claims for 4 years following a baseline interview.
Lifestyle factors (swimming and walking) and functional adaptations (general home modifications) were associated with reductions in monthly Medicare expenditures over a 12-month follow-up period. Expenditure reductions were found over the 48-month follow-up period for participation in active sports, gardening, and medical self-care. Practices associated with increases in expenditures included smoking, physical exercise (possibly of a more strenuous nature), and specific home modifications.
Certain self-care practices appear to have significant implications for Medicare expenditures and presumptively for the health status of older adults. Such practices should be encouraged among older adults as a matter of national health policy.
自我保健包括个人为促进或确保自身健康、从疾病或损伤中康复或应对其影响而采取的行动。本研究在一个65岁及以上成年人的全国样本中，测量了自我保健行为（生活方式行为、对功能限制的适应以及医疗自我保健）与医疗保险支出之间的关联。
通过使用自我保健与老龄化全国调查以及基线访谈后4年的医疗保险理赔数据，对医疗保险使用和支出的回归模型进行了估计。
在12个月的随访期内，生活方式因素（游泳和散步）和功能适应（一般家庭改造）与每月医疗保险支出的减少相关。在48个月的随访期内，发现参与积极运动、园艺和医疗自我保健可降低支出。与支出增加相关的行为包括吸烟、体育锻炼（可能强度更大）和特定的家庭改造。
某些自我保健行为似乎对医疗保险支出以及老年人的健康状况可能具有重大影响。作为一项国家卫生政策，应在老年人中鼓励此类行为。
