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有和没有既定心血管疾病者的中高强度身体活动的经济影响:2012 年医疗支出调查。

Economic Impact of Moderate-Vigorous Physical Activity Among Those With and Without Established Cardiovascular Disease: 2012 Medical Expenditure Panel Survey.

机构信息

Center for Healthcare Advancement and Outcomes, Baptist Health South Florida, Miami, FL.

Center for Healthcare Advancement and Outcomes, Baptist Health South Florida, Miami, FL Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, Miami, FL.

出版信息

J Am Heart Assoc. 2016 Sep 7;5(9):e003614. doi: 10.1161/JAHA.116.003614.

Abstract

BACKGROUND

Physical activity (PA) has an established favorable impact on cardiovascular disease (CVD) outcomes and quality of life. In this study, we aimed to estimate the economic effect of moderate-vigorous PA on medical expenditures and utilization from a nationally representative cohort with and without CVD.

METHODS AND RESULTS

The 2012 Medical Expenditure Panel Survey data were analyzed. Our study population was limited to noninstitutionalized US adults ≥18 years of age. Variables of interest included CVD (coronary artery disease, stroke, heart failure, dysrhythmias, or peripheral artery disease) and cardiovascular modifiable risk factors (CRFs; hypertension, diabetes mellitus, hypercholesterolemia, smoking, and/or obesity). Two-part econometric models were utilized to study cost data; a generalized linear model with gamma distribution and link log was used to assess expenditures per capita. The final study sample included 26 239 surveyed individuals. Overall, 47% engaged in moderate-vigorous PA ≥30 minutes, ≥5 days/week, translating to 111.5 million adults in the United States stratifying by CVD status; 32% reported moderate-vigorous PA among those with CVD versus 49% without CVD. Generally, participants reporting moderate-vigorous PA incurred significantly lower health care expenditures and resource utilization, displaying a step-wise lower total annual health care expenditure as moving from CVD to non-CVD (and each CRF category).

CONCLUSIONS

Moderate-vigorous PA ≥30 minutes, ≥5 days/week is associated with significantly lower health care spending and resource utilization among individuals with and without established CVD.

摘要

背景

身体活动(PA)对心血管疾病(CVD)结局和生活质量有明确的有利影响。在这项研究中,我们旨在从有和没有 CVD 的全国代表性队列中估计中等强度至剧烈 PA 对医疗支出和利用的经济影响。

方法和结果

分析了 2012 年医疗支出面板调查数据。我们的研究人群仅限于非机构化的美国≥18 岁成年人。感兴趣的变量包括 CVD(冠状动脉疾病、中风、心力衰竭、心律失常或外周动脉疾病)和心血管可改变的危险因素(CRFs;高血压、糖尿病、高胆固醇血症、吸烟和/或肥胖)。使用双部分经济计量模型研究成本数据;使用具有伽马分布和对数链接的广义线性模型评估人均支出。最终的研究样本包括 26239 名接受调查的个体。总体而言,47%的人进行了≥30 分钟、≥5 天/周的中等强度至剧烈 PA,按 CVD 状态分层,美国有 1.115 亿成年人;32%报告有 CVD 的人进行了中等强度至剧烈 PA,而没有 CVD 的人则为 49%。一般来说,报告进行中等强度至剧烈 PA 的参与者的医疗保健支出和资源利用显著较低,显示出随着从 CVD 向非 CVD(以及每个 CRF 类别)的转变,总年度医疗保健支出呈逐步下降趋势。

结论

每周至少进行 30 分钟、≥5 天的中等强度至剧烈 PA 与有和没有已确诊 CVD 的个体的医疗保健支出和资源利用显著降低有关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ae91/5079024/08dde35e6122/JAH3-5-e003614-g001.jpg

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