Yan Alice F, Wang Yang, Ng Alexander V
Community and Behavioral Health Promotion, Joseph J. Zilber School of Public Health, University of Wisconsin-Milwaukee, 53205, USA.
Public Health Policy and Administration, Joseph J. Zilber School of Public Health, University of Wisconsin-Milwaukee, 53205, USA.
Prev Med Rep. 2018 Feb 2;9:118-123. doi: 10.1016/j.pmedr.2018.01.003. eCollection 2018 Mar.
Multiple chronic conditions in cancer survivors are highly prevalent and may increase health care costs for both patients and the health care system. Studies of cancer survivors reveal positive effects of physical activity (PA) on reducing risk of cancer recurrence, other chronic conditions, and secondary cancer. Few nationally representative studies have examined how physical activity levels have affected survivors' annual economic burden in the United States. Leisure-time physical activity data from the National Health Interview Survey was linked to health care expenditure data from the Medical Expenditure Panel Survey data (2008-2012). We calculated per-person annual total medical expenditures for identified colorectal, breast, and prostate cancer survivors. We conducted multivariable analyses controlled for survival years and other sociodemographic variables. Generalized linear models were performed to measure correlation between medical expenditure and PA level using STATA 14. All analyses considered the complex survey design and were conducted in 2017. Of 1015 cancer survivors sampled, 30% ( = 305) adhered to physical activity recommendation, while the other 70% ( = 710) did not. Multivariable-adjusted expenditure in adherence group was $9108.8 (95% CI 7410.9-10,806.7) versus 12,899.1 (95% CI 11,450.2-14,348) in non-adherence group. Stratified analyses revealed cancer survivors who adhered to their PA recommendation saved $4686.1 (1-5 years' survival time) and $2874.5 (11 or more years' survival time) on average for total health care expenditure, respectively. Analyses of the national representative sample revealed that the economic burden of survivors from the three most prevalent cancers is substantial. Increasing survivor's PA to guidelines may reduce U.S. health care expenditure.
癌症幸存者中的多种慢性病非常普遍，可能会增加患者和医疗系统的医疗成本。对癌症幸存者的研究表明，体育活动（PA）对降低癌症复发风险、其他慢性病和继发性癌症具有积极作用。很少有全国代表性的研究考察体育活动水平如何影响美国幸存者的年度经济负担。来自国家健康访谈调查的休闲时间体育活动数据与医疗支出小组调查数据（2008 - 2012年）中的医疗保健支出数据相关联。我们计算了已确定的结直肠癌、乳腺癌和前列腺癌幸存者的人均年度总医疗支出。我们进行了多变量分析，控制了生存年限和其他社会人口统计学变量。使用STATA 14进行广义线性模型分析，以测量医疗支出与PA水平之间的相关性。所有分析都考虑了复杂的调查设计，并于2017年进行。在抽取的1015名癌症幸存者中，30%（n = 305）遵守体育活动建议，而另外70%（n = 710）则未遵守。遵守组的多变量调整后支出为9108.8美元（95%可信区间7410.9 - 10806.7），而未遵守组为12899.1美元（95%可信区间11450.2 - 14348）。分层分析显示，遵守PA建议的癌症幸存者在总医疗保健支出上平均分别节省了4686.1美元（生存时间1 - 5年）和2874.5美元（生存时间11年或更长）。对全国代表性样本的分析表明，三种最常见癌症幸存者的经济负担很大。将幸存者的PA提高到指南水平可能会降低美国的医疗保健支出。
