Jonathan Myers1, Christina Grüne de Souza E Silva2, Rachelle Doom3, Holly Fonda3, Khin Chan3, Shirit Kamil-Rosenberg3, Peter Kokkinos4. 1. Veterans Affairs Palo Alto Health Care System, Calif; Division of Cardiovascular Medicine, Stanford University, Calif. Electronic address: drj993@aol.com. 2. Heart Institute Edson Saad/Federal University of Rio de Janeiro, Brazil. 3. Veterans Affairs Palo Alto Health Care System, Calif. 4. Veterans Affairs Medical Center, Washington, DC.
Abstract
BACKGROUND: This study aimed to determine the association between cardiorespiratory fitness and healthcare expenditures among individuals with and without diabetes. METHODS: Health care costs were quantified among 3924 consecutive men (mean age 58 ± 11 years) referred for a maximal exercise test, and compared according to presence (n = 2457) and absence (n = 1467) of diabetes and fitness. Fitness was classified into 4 categories based on age-stratified quartiles of peak metabolic equivalents: least-fit (5.1 ± 1.5 metabolic equivalents; n = 1044), moderately-fit (7.6 ± 1.5 metabolic equivalents; n = 938), fit (9.4 ± 1.5 metabolic equivalents; n = 988), and highly-fit (12.4 ± 2.2 metabolic equivalents; n = 954). Annual costs per subject were quantified over an 8-year period. RESULTS: Age, BMI, and presence of cardiovascular disease (CVD) were similar between subjects with and without diabetes. After adjusting for age and presence of CVD, annual costs per person were higher among diabetics vs. non-diabetics. Individuals with and without diabetes in the highly-fit category had annual costs (US dollars x 103) (mean ± standard deviation) that were on average $32,178 and $30,816 lower, respectively, than individuals in the least-fit category. For each 1-metabolic equivalent higher fitness, annual cost savings per person were $5,193 and $3,603 for individuals with and without diabetes, respectively. CONCLUSIONS: Higher fitness is associated with lower health care costs. Cost savings associated with higher fitness are particularly evident among individuals with diabetes. The economic burden of diabetes may be reduced through interventions that target improvements in fitness. Published by Elsevier Inc.
BACKGROUND: This study aimed to determine the association between cardiorespiratory fitness and healthcare expenditures among individuals with and without diabetes. METHODS: Health care costs were quantified among 3924 consecutive men (mean age 58 ± 11 years) referred for a maximal exercise test, and compared according to presence (n = 2457) and absence (n = 1467) of diabetes and fitness. Fitness was classified into 4 categories based on age-stratified quartiles of peak metabolic equivalents: least-fit (5.1 ± 1.5 metabolic equivalents; n = 1044), moderately-fit (7.6 ± 1.5 metabolic equivalents; n = 938), fit (9.4 ± 1.5 metabolic equivalents; n = 988), and highly-fit (12.4 ± 2.2 metabolic equivalents; n = 954). Annual costs per subject were quantified over an 8-year period. RESULTS: Age, BMI, and presence of cardiovascular disease (CVD) were similar between subjects with and without diabetes. After adjusting for age and presence of CVD, annual costs per person were higher among diabetics vs. non-diabetics. Individuals with and without diabetes in the highly-fit category had annual costs (US dollars x 103) (mean ± standard deviation) that were on average $32,178 and $30,816 lower, respectively, than individuals in the least-fit category. For each 1-metabolic equivalent higher fitness, annual cost savings per person were $5,193 and $3,603 for individuals with and without diabetes, respectively. CONCLUSIONS: Higher fitness is associated with lower health care costs. Cost savings associated with higher fitness are particularly evident among individuals with diabetes. The economic burden of diabetes may be reduced through interventions that target improvements in fitness. Published by Elsevier Inc.
Authors: Marc J Pepin; Willy M Valencia; Janet Prvu Bettger; Megan Pearson; Kenneth M Manning; Richard Sloane; Kenneth E Schmader; Miriam C Morey Journal: Gerontol Geriatr Med Date: 2020-09-19