Kang Sung-Wan, Xiang Xiaoling
School of Social Work, University of Illinois at Urbana-Champaign, 1010 W. Nevada, Urbana, IL 61801, USA.
Center for Education in Health Sciences, Northwestern University Feinberg School of Medicine, 633 N Saint Clair Street, Chicago, IL 60611, USA.
Prev Med. 2017 Mar;96:101-105. doi: 10.1016/j.ypmed.2016.12.043. Epub 2016 Dec 29.
The objective of this study was to examine the relationship between physical activity and health services utilization and costs among adults aged 18 or older in the U.S. Data came from the Medical Expenditure Panel Survey-Household component from 2007 through 2011 (n=117,361). Regular physical activity was defined as spending half an hour or more in moderate or vigorous physical activity at least three times a week. The following categories of self-reported health services utilization and costs were examined: preventive, office-based, outpatient, inpatient, emergency department, home health, and prescription medicines. The association of physical activity and health services utilization and costs was estimated using two-part models. Adults who engaged in regular physical activity were more likely to use preventive (ORs ranged from 1.06 to 1.34, p<0.05) and office-based services (OR=1.05, 95% CI=1.01-1.10, p<0.05). Combining results from both parts of the two-part models, physically active adults incurred significantly lower utilization of inpatient (0.09 vs 0.12 visit per person), emergency room (0.18 vs 0.19 visit per person), home health care (1.21 vs 1.92 visit per person), and prescription medicines (12.66 vs 13.75 number of prescriptions per person) and spent $27 less per capita expenditures for office-based visits, $351 less for inpatient visits, and $52 less for home health care visits. Promoting regular physical activity may reduce health care costs through decreasing demand for secondary and tertiary care services.
本研究的目的是调查美国18岁及以上成年人的身体活动与医疗服务利用及成本之间的关系。数据来自2007年至2011年的医疗支出小组调查家庭部分(n = 117,361)。定期身体活动的定义是每周至少三次进行半小时或更长时间的中等强度或剧烈身体活动。研究考察了以下几类自我报告的医疗服务利用情况和成本:预防性、门诊、住院、急诊科、家庭保健和处方药。使用两部分模型估计身体活动与医疗服务利用及成本之间的关联。进行定期身体活动的成年人更有可能使用预防性服务(比值比范围为1.06至1.34,p<0.05)和门诊服务(比值比=1.05,95%置信区间=1.01 - 1.10,p<0.05)。综合两部分模型的结果,身体活跃的成年人住院(每人就诊0.09次对0.12次)、急诊室(每人就诊0.18次对0.19次)、家庭保健(每人就诊1.21次对1.92次)和处方药(每人处方数量12.66对13.75)利用显著降低,且门诊就诊人均支出少27美元,住院就诊少351美元,家庭保健就诊少52美元。促进定期身体活动可能通过减少对二级和三级护理服务的需求来降低医疗成本。