(1)The University of Newcastle Faculty of Health and Medicine, Callaghan, NSW, Australia; (2)The University of Newcastle Priority Research Centre for Physical Activity and Nutrition, Callaghan, NSW, Australia.
(3)The University of Newcastle Priority Research Centre for Generational Health and Ageing, New Lambton, New South Wales, Australia.
J Acad Nutr Diet. 2021 Apr;121(4):655-668. doi: 10.1016/j.jand.2020.12.012. Epub 2021 Jan 22.
The relationship between diet quality and health care costs is unclear.
The aim of this study was to investigate the relationship between baseline diet quality and change in diet quality over time, with 15-year cumulative health care claims/costs.
Data from a longitudinal cohort study were analyzed.
PARTICIPANTS/SETTING: Data for survey 3 (2001) (n = 7,868) and survey 7 (2013) (n = 6,349 both time points) from the 1946-1951 cohort of the Australian Longitudinal Study on Women's Health were analyzed.
Diet quality was assessed using the Australian Recommended Food Score (ARFS). Fifteen-year cumulative Medicare Benefits Schedule (Australia's universal health care coverage) data were reported by baseline ARFS quintile and category of diet quality change ("diet quality worsened" [ARFS change ≤ -4 points], "remained stable" [-3 ≤ change in ARFS ≤3 points], or "improved" [ARFS change ≥4 points]).
Linear regression analyses were conducted adjusting for area of residence, socioeconomic status, lifestyle factors, and private health insurance status.
Consuming a greater variety of vegetables at baseline but fewer fruit and dairy products was associated with lower health care costs. For every 1-point increment in the ARFS vegetable subscale, women made 3.3 (95% CI, 1.6-5.0) fewer claims and incurred AU$227 (95% CI, AU$104-350 [US$158; 95% CI, US$72-243]) less in costs. Women whose diet quality worsened over time made more claims (median, 251 claims; quintile 1, quintile 3 [Q1; Q3], 168; 368 claims) and incurred higher costs (AU$15,519; Q1; Q3, AU$9,226; AU$24,847 [US$10,793; Q1; Q3, US$6,417; US$17,281]) compared with those whose diet quality remained stable (median, 236 claims [Q1; Q3, 158; 346 claims], AU$14,515; Q1; Q3, AU$8,539; AU$23,378 [US$10,095; Q1; Q3, US$5,939; US$16,259]).
Greater vegetable variety was associated with fewer health care claims and costs; however, this trend was not consistent across other subscales. Worsening diet quality over 12 years was linked with higher health care claims and costs.
饮食质量与医疗保健费用之间的关系尚不清楚。
本研究旨在调查基线饮食质量与随时间变化的饮食质量变化之间的关系，以及 15 年的累计医疗保健费用/成本。
对一项纵向队列研究的数据进行了分析。
参与者/设置：对澳大利亚女性健康纵向研究 1946-1951 队列研究的第 3 次调查（2001 年）（n=7868）和第 7 次调查（2013 年）（n=6349，两次调查均在时间点）的数据进行了分析。
使用澳大利亚推荐食物评分（ARFS）评估饮食质量。根据基线 ARFS 五分位数和饮食质量变化类别（“饮食质量恶化”[ARFS 变化≤-4 分]、“保持稳定”[-3≤ARFS 变化≤3 分]或“改善”[ARFS 变化≥4 分]）报告了 15 年的累积医疗保险福利计划（澳大利亚全民医疗保健覆盖）数据。
通过调整居住区域、社会经济地位、生活方式因素和私人医疗保险状况，进行线性回归分析。
基线时摄入更多种类的蔬菜但水果和奶制品较少与较低的医疗保健费用相关。ARFS 蔬菜分量表每增加 1 分，女性的索赔数量减少 3.3（95%CI，1.6-5.0），成本减少 227 澳元（95%CI，104-350 澳元[158 美元；95%CI，72-243 美元]）。随着时间的推移，饮食质量恶化的女性的索赔更多（中位数为 251 次索赔；五分位数 1，五分位数 3[Q1；Q3]，168；368 次索赔），成本更高（15519 澳元；Q1；Q3，9226 澳元；24847 澳元[10793 美元；Q1；Q3，6417 美元；17281 美元]）与饮食质量保持稳定的女性相比（中位数为 236 次索赔[Q1；Q3，158；346 次索赔]，14515 澳元；Q1；Q3，8539 澳元；23378 澳元[10095 美元；Q1；Q3，5939 美元；16259 美元]）。
蔬菜种类的增加与医疗保健费用的减少有关；然而，这种趋势在其他分量表中并不一致。12 年来饮食质量恶化与更高的医疗保健费用有关。
