B E Saelens1, R T Meenan2, E M Keast2, L D Frank3, D R Young4, J L Kuntz2, J F Dickerson2, S P Fortmann2. 1. Seattle Children's Research Institute and the Department of Pediatrics at the University of Washington, 1920 Terry Avenue, Seattle, Washington USA 98101. 2. Center for Health Research, Kaiser Permanente Northwest, 3800 N. Interstate Ave, Portland, Oregon USA 97227-1098. 3. Urban Design 4 Health, Inc., Rochester, NY and Health & Community Design Lab, Schools of Population and Public Health and Community and Regional Planning, University of British Columbia, 433 - 6333 Memorial Road Vancouver, BC Canada V6T 1Z2. 4. Center for Research & Evaluation, Kaiser Permanente Southern California, 100 S. Los Robles Ave, Pasadena, CA U.S. 91101.
Abstract
INTRODUCTION: Greater transit use is associated with higher levels of physical activity, which is associated with lower health risks and better health outcomes. However, there is scant evidence about whether health care costs differ based on level of transit ridership. METHODS: A sample (n=947) of members of Kaiser Permanente in the Portland, Oregon area were surveyed in 2015 about their typical use of various modes of travel including transit. Electronic medical record-derived health care costs were obtained among these members for the prior three years. Analysis examined proportional costs between High transit users (3+ days/week), Low transit users (1-2 days/week), and Non-users adjusting for age and sex, and then individually (base models) and together for demographic and health status variables. RESULTS: In separate base models across individual covariates, High transit users had lower total health care costs (59-69% of Non-user's costs) and medication costs (31-37% of Non-users' costs) than Non-users. Low transit users also had lower total health care (69%-76% of Non-users' costs) and medication costs (43-57% transit of Non-user's costs) than Non-users. High transit users' outpatient costs were also lower (77-82% of Non-users). In fully-adjusted models, total health care and medication costs were lower among High transit users' (67% and 39%) and Low transit users' (75% and 48%) compared to Non-users, but outpatient costs did not differ by transit use. CONCLUSIONS: Findings have implications for the potential cost benefit of encouraging and supporting more transit use, although controlled longitudinal and experimental evidence is needed to confirm findings and understand mechanisms.
INTRODUCTION: Greater transit use is associated with higher levels of physical activity, which is associated with lower health risks and better health outcomes. However, there is scant evidence about whether health care costs differ based on level of transit ridership. METHODS: A sample (n=947) of members of Kaiser Permanente in the Portland, Oregon area were surveyed in 2015 about their typical use of various modes of travel including transit. Electronic medical record-derived health care costs were obtained among these members for the prior three years. Analysis examined proportional costs between High transit users (3+ days/week), Low transit users (1-2 days/week), and Non-users adjusting for age and sex, and then individually (base models) and together for demographic and health status variables. RESULTS: In separate base models across individual covariates, High transit users had lower total health care costs (59-69% of Non-user's costs) and medication costs (31-37% of Non-users' costs) than Non-users. Low transit users also had lower total health care (69%-76% of Non-users' costs) and medication costs (43-57% transit of Non-user's costs) than Non-users. High transit users' outpatient costs were also lower (77-82% of Non-users). In fully-adjusted models, total health care and medication costs were lower among High transit users' (67% and 39%) and Low transit users' (75% and 48%) compared to Non-users, but outpatient costs did not differ by transit use. CONCLUSIONS: Findings have implications for the potential cost benefit of encouraging and supporting more transit use, although controlled longitudinal and experimental evidence is needed to confirm findings and understand mechanisms.
Entities:
Keywords:
health care costs; medical expenditures; public transportation; transit
Authors: Alfredo Morabia; Franklin E Mirer; Tashia M Amstislavski; Holger M Eisl; Jordan Werbe-Fuentes; John Gorczynski; Chris Goranson; Mary S Wolff; Steven B Markowitz Journal: Am J Public Health Date: 2010-10-21 Impact factor: 9.308
Authors: Maureen C O'Keeffe-Rosetti; Mark C Hornbrook; Paul A Fishman; Debra P Ritzwoller; Erin M Keast; Jenny Staab; Jennifer Elston Lafata; Ramzi Salloum Journal: J Natl Cancer Inst Monogr Date: 2013