Department of Regional Social Management, Faculty of Life and Environmental Sciences, University of Yamanashi, 4-4-37 Takeda, Kofu-shi, Yamanashi 400-8510, Japan.
Faculty of Social Welfare, Nihon Fukushi University, Okuda, Mihama-cho, Chita-gun, Aichi 470-3295, Japan.
Int J Environ Res Public Health. 2021 May 9;18(9):5004. doi: 10.3390/ijerph18095004.
This study aimed to determine the impact of physical activity on the cumulative cost of long-term care insurance (LTCI) services in a cohort of community-dwelling people (65 years and older) in Japan. Using cohort data from the Japan Gerontological Evaluation Study (JAGES) on those who were functionally independent as of 2010/11, we examined differences in the cumulative cost of LTCI services by physical activity. We followed 38,875 participants with LTCI service costs for 59 months. Physical activity was assessed by the frequency of going out and time spent walking. We adopted a generalized linear model with gamma distribution and log-link function, and a classical linear regression with multiple imputation. The cumulative LTCI costs significantly decreased with the frequency of going out and the time spent walking after adjustment for baseline covariates. LTCI's cumulative cost for those who went out once a week or less was USD 600 higher than those who went out almost daily. Furthermore, costs for those who walked for less than 30 min were USD 900 higher than those who walked for more than 60 min. Physical activity among older individuals can reduce LTCI costs, which could provide a rationale for expenditure intervention programs that promote physical activity.
本研究旨在确定身体活动对日本社区居住人群(65 岁及以上)长期护理保险(LTCI)服务累计成本的影响。本研究使用了日本老年人评估研究(JAGES)的队列数据,该数据包含了截至 2010/11 年功能独立的人群,我们通过身体活动检查了 LTCI 服务累计成本的差异。我们对 38875 名有 LTCI 服务费用的参与者进行了 59 个月的随访。身体活动通过外出频率和步行时间来评估。我们采用了具有伽马分布和对数链接函数的广义线性模型,以及具有多重插补的经典线性回归。在调整了基线协变量后,外出频率和步行时间与 LTCI 的累计成本显著降低。每周外出一次或更少的人的 LTCI 累计成本比几乎每天外出的人高 600 美元。此外,步行时间少于 30 分钟的人的成本比步行时间超过 60 分钟的人高 900 美元。老年人的身体活动可以降低 LTCI 成本,这为促进身体活动的支出干预计划提供了依据。