Am J Prev Med 2005; 29(5):379–387
Lifestyle Risk Factors Predict Healthcare Costs in an
Aging Cohort
J. Paul Leigh, PhD, Helen B. Hubert, MPH, PhD, Patrick S. Romano, MD
Background: While the U.S. elderly population uses a disproportionate amount of healthcare resources,
there is limited knowledge from prospective studies regarding the impact of lifestyle related
factors on costs in this group. The association was examined between smoking,
drinking, exercise, body mass index (BMI), and changes in these risk factors, and
healthcare costs after 4 years among 68- to 95-year-olds.
Methods: A total of 1323 participants completed annual surveys providing information on lifestyle
factors (1986–1994) and health utilization (1994–1998). Healthcare costs in nine categories
were ascertained from validated utilization. The relationships between risk factors and
costs were examined in 2004 using linear regression models.
Results: Fewer cigarette pack-years and lower BMI were the most significant predictors of lower total costs in 1998 (p 0.001), controlling for baseline sociodemographic factors, costs, and
conditions. Associations with smoking were strongest for hospitalizations, diagnostic tests,
and physician and nursing-home visits. Those who reduced smoking by one pack per day
experienced cost savings of $1160 (p 0.05). The costs for normal weight compared to
minimally obese seniors were approximately $1548 lower, with diagnostic testing, physician
visits, and medications accounting for much of this difference. Daily walking, measured at
baseline, also predicted lower costs for hospitalizations and diagnostic testing.
Conclusions: Seniors who were leaner, smoked fewer cigarettes over a lifetime, reduced their smoking, or walked farther had significant subsequent cost savings compared to those with
less-healthy lifestyle-related habits.
>>>>>>>>>>>>>>>>>>
BrooklynDodger Comments: The main concern here another factoid to blame illness and cost on the victims, as a softening up to cut health care insurance to put the victims on the risk.
The abstract would be improved by noting that these were survey results in a cohort of university alumni, which likely makes results very class specific. The full text reveals that 29% died in the course of observation. The Dodger is unclear on whether early death was taken into account in the impact of bad behavior on total health care costs. Early death would likely save money.
The most interesting part of the paper was the analysis of cost by category:
Table 1. 1998 healthcare costs by resource category, men and women aged 68 to 95 years
Cost category......................................................Mean
Total costs, 1998 ...............................................$4732
1. Outpatient diagnostic tests......................... $1342
2. Hospital stays..................................................$1263
3. Prescription and nonprescription medications.........$943
4. Physician visits.................................................$724
5. Outpatient surgeries........................................$241
6. Emergency department visits..........................$79
7. Home healthcare visits........................................$66
8. Nursing home and rehabilitation stays..............$54
9. Nontraditional therapy visits.............................$22
>>>>>>>>>>>>>>>>>>>>>>>>>>>
The mean cost would equate to $9400 per year for an elderly couple. What does Medicare cost, and what is left over from medicare? Does this add up?
Surprising to the Dodger, outpatient diagnostic tests and physician visits way topped hospital costs. Did the hospital costs include the inpatient doctor charges? Do the prescription drug charges include the inpatient drugs? The Dodger would spin this as patients trying to stay healthy and live longer, but others might say this was evidence for voluntary behavior contributing to costs.
Drinks per week had no effect on costs. Excercise had no effect on costs although miles walked did [confounding with healthier at baseline.]
No comments:
Post a Comment