1
|
Alfaifi A. Association between non-pharmacological therapy and healthcare use and expenditure of patients with diabetes mellitus. Saudi Pharm J 2023; 31:101685. [PMID: 37448845 PMCID: PMC10336783 DOI: 10.1016/j.jsps.2023.06.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 06/18/2023] [Indexed: 07/15/2023] Open
Abstract
This study explored the sociodemographic and clinical characteristics of patients with diabetes who incorporated two non-pharmacological therapies into their lifestyle and the association between non-pharmacological therapy and healthcare utilization and expenditure. In the USA, 26.4 million people were reportedly diagnosed with diabetes and treated with diet modification or physical activity in the 2019 Medical Expenditure Panel Survey. Physical activity was defined as moderate-to-vigorous physical exercise five times per week, whereas dietary modification involved healthy eating that reduced glucose levels. Only 4.8 million patients with diabetes did not integrate any non-pharmacological intervention into their therapy regimen. Those who did not include non-pharmacological interventions had higher annual total healthcare expenditures (M = $18,428) than those who incorporated either single (M = $17,058) or dual intervention (M = $15,134). A significant difference was observed in prescribed medicine utilization per year for those who did not include lifestyle modifications or non-pharmacological interventions. Propensity score-matched participants revealed significant differences in hospital stays, outpatient visits, and emergency department expenditures. Patients with diabetes who adhered to two non-pharmacological interventions showed significantly lower healthcare utilization. Being active and following a healthy diet can help prevent the progression of diabetes mellitus complications and reduce the cost associated with diabetes.
Collapse
|
2
|
Chen L, Xu X. Relationships between the Physical Activity Intensity and the Medical Expenditure of Middle-Aged and Elderly People: Parsing from the CHARLS Database. Behav Sci (Basel) 2023; 13:566. [PMID: 37504013 PMCID: PMC10376150 DOI: 10.3390/bs13070566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 06/24/2023] [Accepted: 07/03/2023] [Indexed: 07/29/2023] Open
Abstract
There are many studies on the impact of physical activity on health but few studies on the relationship between physical activity and medical expenditure among the elderly. Based on the China Health and Retirement Longitudinal Survey (CHARLS) database and selected 4456 valid samples, this paper used a two-part model to analyze the effects of high, moderate, and low physical activity intensity on medical expenditure. It is found that the intensity of physical activity was negatively correlated with medical expenditure, and the medical expenditure of the high physical activity intensity group was significantly lower than that of the low physical activity intensity group. For example, compared to people with no physical activity, the total medical expenditure decreased by 22.4%, 40.4%, and 62.5% per week in those with low, moderate, and high physical activity intensity. Thus, the government should provide more places for the elderly to exercise, planning special exercise areas for the elderly in community playgrounds, such as a dancing square, which will also help the elderly to increase their amount of exercise per week and develop a daily exercise habit.
Collapse
Affiliation(s)
- Linhong Chen
- School of Marxism, Chongqing Technology and Business University, Chongqing 400067, China
| | - Xiaocang Xu
- School of Economics and Management, Huzhou University, Huzhou 313000, China
| |
Collapse
|
3
|
Associations between Physical Activity Level and Health Services Use in Spanish Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148867. [PMID: 35886715 PMCID: PMC9321179 DOI: 10.3390/ijerph19148867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 07/15/2022] [Accepted: 07/18/2022] [Indexed: 11/16/2022]
Abstract
One of the main concerns of governments and organisations worldwide is the cost and burden of health services, with sedentary lifestyles being a significant impacting factor, and physical activity is one of the potential solutions. Therefore, this study aims to analyse the possible associations between the physical activity level, hospitalisation prevalence, and the use and number of visits to emergency services in the Spanish population, examining potential differences between sex and age groups. This is a cross-sectional study based on data from the Spanish National Health Survey 2017 (ENSE 2017), the last one before the COVID-19 pandemic, with 17,199 participants. A descriptive analysis was performed using median and interquartile range (continuous variables) and absolute and relative frequencies (ordinal variables). Intergroup differences were analysed with non-parametric tests: chi-square and z-test for independent proportions (categorical variables), and Kruskal−Wallis and Mann−Whitney U (continuous variables). Spearman’s rho was used to study correlations between variables. A multiple binary regression analysis was performed to predict hospitalisations. Hospitalisations and emergency services use showed a dependence relation with the physical activity level (p < 0.001): those who performed moderate and/or vigorous physical activity used those services less than sedentary individuals and those whose only activity was walking. Thus, associations could be drawn between the hospitalisation prevalence, the use and number of visits to emergency departments, and the physical activity level in the Spanish population aged 18−69 years in the pre-pandemic period.
Collapse
|
4
|
Huang X, Zhu W, Gao X, Yu D, Jin H, Huang J, Yu W, Lv Y, Zhou L, Chen N, Yang Y, Wang Z, Shi J. Relationship Between Old-Aged Preferences Regarding Various Types of Physical Activity and Chronic Disease Status: A Cross-Sectional Study in Shanghai, China. Front Public Health 2022; 10:865328. [PMID: 35433623 PMCID: PMC9006984 DOI: 10.3389/fpubh.2022.865328] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Accepted: 02/25/2022] [Indexed: 11/13/2022] Open
Abstract
Background A lack of physical activity (PA) is a threat to public health. However, for the elderly, most PA abilities are limited. By focusing on the types and intensity of PA that the elderly can bear, this study aimed to reveal whether preferences regarding types of PA (including housework, transportation, and recreational activities) and their intensity were associated with health status. The main forms of PA include shopping, cooking, cleaning, walking, cycling, various fitness activities and other activities with a certain intensity. Methods Surveillance data on chronic diseases and their risk factors were collected from one district of Shanghai in 2017-2018. A Kish table was used for sampling 500 older adults, including the diagnosed group (chronic diseases diagnosed by physicians, n = 119), the abnormal group (not diagnosed but abnormal indicators detected in this investigation, n = 287) and the healthy group (n = 94). Multiple regressions were used to test the relationship between the various types, durations and intensities of PA the elderly individuals participated in and their health status. Results All three groups included a large proportion of older adults who participated in housework- and transport-related PA. The diagnosed group had the largest proportion (63.06% for housework-related PA; 87.39% for transport-related PA) and median minutes (17.14 min of housework-related PA per day; 30.00 min of transport-related PA per day). The diagnosed group had more metabolic equivalents (METs) of moderate-intensity PA than the two other groups (H = 33.01, P < 0.01), and more people met the WHO recommendation (χ2 = 34.71, P < 0.01). Diagnosis was associated with performing housework- and transport-related PA and moderate-intensity PA and with meeting the WHO's recommendation. Higher education levels were a positive factor for elderly individuals to participate in PA. Conclusions Transportation and housework activities are good targets for increasing PA in older adults. Diagnosis is associated with older adults' more PA.
Collapse
Affiliation(s)
- Xiaojing Huang
- School of Management, Xuzhou Medical University, Xuzhou, China
| | - Wenqing Zhu
- Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Xiang Gao
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Dehua Yu
- Department of General Practice, Yangpu Hospital, Tongji University School of Medicine, Shanghai, China
- Academic Department of General Practice, Tongji University School of Medicine, Shanghai, China
- Shanghai General Practice and Community Health Development Research Center, Shanghai, China
| | - Hua Jin
- Department of General Practice, Yangpu Hospital, Tongji University School of Medicine, Shanghai, China
- Academic Department of General Practice, Tongji University School of Medicine, Shanghai, China
- Shanghai General Practice and Community Health Development Research Center, Shanghai, China
| | - Jiaoling Huang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wenya Yu
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yipeng Lv
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Liang Zhou
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ning Chen
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yan Yang
- School of Economics and Management, Tongji University, Shanghai, China
| | - Zhaoxin Wang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- *Correspondence: Jianwei Shi
| | - Jianwei Shi
- Department of General Practice, Yangpu Hospital, Tongji University School of Medicine, Shanghai, China
- Department of Social Medicine and Health Management of School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Zhaoxin Wang
| |
Collapse
|
5
|
Jagroep W, Cramm JM, Denktaș S, Nieboer AP. Age-friendly neighbourhoods and physical activity of older Surinamese individuals in Rotterdam, the Netherlands. PLoS One 2022; 17:e0261998. [PMID: 35085282 PMCID: PMC8794150 DOI: 10.1371/journal.pone.0261998] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 12/15/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Age-friendly neighbourhoods seem to promote physical activity among older individuals. Physical activity is especially important for chronically ill individuals. In the Netherlands, older Surinamese individuals are more likely to have chronic diseases than are their native Dutch counterparts. This study examined relationships of neighbourhood characteristics with physical activity among older Surinamese individuals in Rotterdam, the Netherlands. METHODS Of 2749 potential participants, 697 (25%) community-dwelling older (age ≥ 70 years) Surinamese individuals living in Rotterdam, the Netherlands, completed a questionnaire on personal and neighbourhood characteristics between March and June 2020. Correlation and multilevel regression analyses were performed to identify associations between missing neighbourhood characteristics for ageing in place and physical activity. RESULTS Scores for the neighbourhood domains communication and information (r = -0.099, p ≤ 0.05), community support and health services (r = -0.139, p ≤ 0.001), and respect and social inclusion (r = -0.141, p ≤ 0.001), correlated negatively with participants' PA. In the multilevel analysis, overall missing neighbourhood characteristics to age in place scores were associated negatively with physical activity (p ≤ 0.05). CONCLUSION This study showed the importance of age-friendly neighbourhoods for physical activity among older Surinamese individuals in Rotterdam, the Netherlands. Our findings suggest that the neighbourhood plays an important role in supporting older individuals' leading of physically active lifestyles. Further research is needed to support the development of interventions to create age-friendly neighbourhoods.
Collapse
Affiliation(s)
- Warsha Jagroep
- Department of Socio-Medical Sciences, Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, the Netherlands
| | - Jane M. Cramm
- Department of Socio-Medical Sciences, Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, the Netherlands
| | - Semiha Denktaș
- Department of Psychology, Education and Child Studies, Erasmus School of Social and Behavioural Sciences, Erasmus University Rotterdam, Rotterdam, the Netherlands
| | - Anna P. Nieboer
- Department of Socio-Medical Sciences, Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, the Netherlands
| |
Collapse
|
6
|
Silva DAS. Hospitalization and ambulatory costs related to breast cancer due to physical inactivity in the Brazilian state capitals. PLoS One 2022; 17:e0261019. [PMID: 35045087 PMCID: PMC8769291 DOI: 10.1371/journal.pone.0261019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 11/22/2021] [Indexed: 01/04/2023] Open
Abstract
The aim of this study was to estimate the hospitalization and ambulatory costs related to breast cancer due to physical inactivity in the female population from Brazilian capitals over a three-year period (2015 to 2017). This study was carried out with data from the Brazilian health system and had as metrics incidence of breast cancer, total and standardized rate hospitalizations by breast cancer, hospitalization and ambulatory costs by breast cancer and prevalence of physical inactivity. The Population Attributable Fraction (PAF) calculation was used. The total hospitalization cost by breast cancer in women aged ≥ 20 years in Brazil from 2015 to 2017 was US$ 33,484,920.54. Of this total, US$ 182,736.76 was due to physical inactivity. Outpatient expenses related to breast cancer in the Brazilian female population from 2015 to 2017 was US$ 207,993,744.39. Of this total, US$ 1,178,841.86 was due to physical inactivity. Outpatient and hospitalization expenses were higher in the states of Southeastern, Southern and Northeastern regions. Physical inactivity has contributed to the high number of hospitalizations for breast cancer in Brazil, which resulted in economic burden for health services (inpatient and outpatient) of more than US$ 1,300,000.00 from 2015 to 2017.
Collapse
Affiliation(s)
- Diego Augusto Santos Silva
- Research Center in Kinanthropometry and Human Performance, Sports Center, Federal University of Santa Catarina, Florianopolis, Brazil
- * E-mail:
| |
Collapse
|
7
|
Lonardo A, Arab JP, Arrese M. Perspectives on Precision Medicine Approaches to NAFLD Diagnosis and Management. Adv Ther 2021; 38:2130-2158. [PMID: 33829368 PMCID: PMC8107169 DOI: 10.1007/s12325-021-01690-1] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 02/26/2021] [Indexed: 02/06/2023]
Abstract
Precision medicine defines the attempt to identify the most effective approaches for specific subsets of patients based on their genetic background, clinical features, and environmental factors. Nonalcoholic fatty liver disease (NAFLD) encompasses the alcohol-like spectrum of liver disorders (steatosis, steatohepatitis with/without fibrosis, and cirrhosis and hepatocellular carcinoma) in the nonalcoholic patient. Recently, disease renaming to MAFLD [metabolic (dysfunction)-associated fatty liver disease] and positive criteria for diagnosis have been proposed. This review article is specifically devoted to envisaging some clues that may be useful to implementing a precision medicine-oriented approach in research and clinical practice. To this end, we focus on how sex and reproductive status, genetics, intestinal microbiota diversity, endocrine and metabolic status, as well as physical activity may interact in determining NAFLD/MAFLD heterogeneity. All these factors should be considered in the individual patient with the aim of implementing an individualized therapeutic plan. The impact of considering NAFLD heterogeneity on the development of targeted therapies for NAFLD subgroups is also extensively discussed.
Collapse
Affiliation(s)
- Amedeo Lonardo
- Department of Internal Medicine, Azienda Ospedaliero-Universitaria, Ospedale Civile di Baggiovara, 1135 Via Giardini, 41126, Modena, Italy.
| | - Juan Pablo Arab
- Departamento de Gastroenterología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
- Departamento de Biología Celular y Molecular, Centro de Envejecimiento y Regeneración (CARE), Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Marco Arrese
- Departamento de Gastroenterología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
- Departamento de Biología Celular y Molecular, Centro de Envejecimiento y Regeneración (CARE), Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile, Santiago, Chile
| |
Collapse
|