Wednesday, January 17, 2007

HMO fitness program may lower health care costs

By Charnicia Huggins

NEW YORK (Reuters Health) - Offering seniors with diabetes the opportunity to participate in a subsidized community-based exercise program may help lower health care costs, if the seniors attend the fitness classes regularly, preliminary study findings suggest.

"These findings warrant additional investigations to determine whether policies to offer and promote a community-based physical activity benefit in older adults with diabetes can reduce health care costs," conclude Dr. Huong Q. Nguyen, of the University of Washington, in Seattle, Washington, and colleagues.

According to previous research, nearly one in five Medicare recipients have diabetes, and diabetes-related health care costs account for about a third of total Medicare expenditures.

The benefits of exercise, particularly important for diabetics, who are at risk of having more functional disability, include reduced health care costs and better physical functioning. Yet, few seniors report participating in regular, moderate-intensity physical activity.

Observational data suggest that health care costs can be greatly reduced among a previously sedentary older adult who engages in moderate physical activity three days a week or more. Nguyen and colleagues investigated whether a physical exercise program offered to seniors as part of their Medicare benefit would also reduce health care costs and utilization.

They analyzed data from an HMO, focusing on 163 seniors, aged 75 years on average, with diabetes who participated in a community-based fitness program that was fully subsidized by the HMO. For comparison, the study also included 364 adults who did not participate in the fitness program.

At follow-up, 12 months later, the researchers found that total health care costs did not differ among the two groups of seniors. However, health care costs among seniors who attended more than the average number of fitness classes per week -- about one -- were roughly 41 percent less than among seniors who attended fewer exercise sessions and among seniors in the comparison group, respectively, Nguyen and colleagues report in Diabetes Care.

"We can not be sure if the exercise actually reduced health care costs or if people who were healthier were able to participate in more exercise classes and therefore had lower health care costs," Nguyen told Reuters Health.

Still, Nguyen added, "in general, any amount of physical activity is beneficial for everyone and it is even more so for people with diabetes and other chronic conditions, regardless of effects on health care costs."

SOURCE: Diabetes Care, January 2007.

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