Department of Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada; Chronic Disease Innovation Centre, Seven Oaks General Hospital, Winnipeg, Manitoba, Canada.
Department of Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada; Manitoba Centre for Health Policy, Department of Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada; Department of Family Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.
Am J Prev Med. 2021 Nov;61(5):e215-e224. doi: 10.1016/j.amepre.2021.05.011.
Interventions that increase physical activity behavior can reduce morbidity and prolong life, but long-term effects in large populations are unproven. This study investigates the association of medical fitness facility membership and frequency of attendance with all-cause mortality and rate of hospitalization.
A propensity weighted retrospective cohort study was conducted by linking individuals who attended medical fitness facilities in Winnipeg, Canada to provincial health administrative databases. Members aged ≥18 years who had ≥1 year of provincial health coverage from their index date between January 1, 2005 and December 31, 2015 were included. Controls were assigned a pseudo-index date at random on the basis of the frequency distribution of index dates in the intervention group. Members were stratified into low-frequency attenders (<1 weekly visit), moderate-frequency attenders (1-3 weekly visits), and high-frequency attenders (>3 weekly visits). The primary outcomes were time to all-cause mortality and rate of hospitalizations. Statistical analyses were performed between 2018 and 2020.
Among 19,300 adult members and 515,810 controls, members had a 60% lower risk of all-cause mortality during the first 651 days and 48% after 651 days. Membership was associated with a 13% lower risk of hospitalizations. A dose-response effect was apparent because higher weekly attendance was associated with a lower risk of hospitalizations (low frequency: 9%, moderate frequency: 20%, high frequency: 39%).
Membership at a medical fitness facility was associated with a reduced risk of all-cause mortality and hospitalizations. Healthcare systems should consider the medical fitness model as a preventative public health strategy to encourage physical activity participation.
增加身体活动行为的干预措施可以降低发病率和延长寿命，但在大人群中的长期效果尚未得到证实。本研究调查了参加医疗健身设施的会员身份和出勤率与全因死亡率和住院率的关系。
通过将在加拿大温尼伯参加医疗健身设施的个人与省级卫生行政数据库联系起来，进行了一项倾向加权回顾性队列研究。符合条件的参与者为年龄≥18 岁，在其索引日期（2005 年 1 月 1 日至 2015 年 12 月 31 日）期间至少有 1 年的省级健康保险。对照者按照干预组索引日期的频率分布随机分配伪索引日期。将成员分为低频率参与者（每周就诊次数<1 次）、中频率参与者（每周就诊次数 1-3 次）和高频率参与者（每周就诊次数>3 次）。主要结果是全因死亡率和住院率的时间。统计分析于 2018 年至 2020 年进行。
在 19300 名成年成员和 515810 名对照者中，成员在最初的 651 天内全因死亡率降低 60%，651 天后死亡率降低 48%。会员资格与住院率降低 13%相关。每周就诊频率越高，与住院率降低之间存在明显的剂量反应关系（低频率：9%，中频率：20%，高频率：39%）。
参加医疗健身设施与全因死亡率和住院率降低相关。医疗保健系统应考虑将医疗健身模式作为一种预防性公共卫生策略，以鼓励身体活动的参与。
