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Cardiovascular Health and Healthcare Utilization and Expenditures Among Medicare Beneficiaries: The REasons for Geographic And Racial Differences in Stroke (REGARDS) Study.

TitleCardiovascular Health and Healthcare Utilization and Expenditures Among Medicare Beneficiaries: The REasons for Geographic And Racial Differences in Stroke (REGARDS) Study.
Publication TypeJournal Article
Year of Publication2017
AuthorsAaron, KJ, Colantonio, LD, Deng, L, Judd, SE, Locher, JL, Safford, MM, Cushman, M, Kilgore, ML, Becker, DJ, Muntner, P
JournalJ Am Heart Assoc
Volume6
Issue2
Date Published2017 02 01
ISSN2047-9980
KeywordsAged, Cardiovascular Diseases, Continental Population Groups, Female, Health Expenditures, Health Status, Health Surveys, Humans, Incidence, Life Style, Male, Medicare, Patient Acceptance of Health Care, Prevalence, Risk Factors, Stroke, United States
Abstract

BACKGROUND: Better cardiovascular health is associated with lower cardiovascular disease risk.METHODS AND RESULTS: We determined the association between cardiovascular health and healthcare utilization and expenditures in the REasons for Geographic And Racial Differences in Stroke (REGARDS) study. We included 6262 participants ≥65 years with Medicare fee-for-service coverage for the year after their baseline study visit in 2003-2007. Cardiovascular health at baseline was assessed using the American Heart Association's Life's Simple 7 (LS7) metric, which includes 7 factors: cigarette smoking, physical activity, diet, body mass index, blood pressure, cholesterol, and glucose. Healthcare utilization and expenditures were ascertained using Medicare claims in the year following baseline. Overall, 17.2%, 31.1%, 29.0%, 16.4% and 6.4% of participants had 0 to 1, 2, 3, 4, and 5 to 7 ideal LS7 factors, respectively. The multivariable-adjusted relative risk (95% confidence interval [CI]) for having any inpatient and outpatient encounters comparing participants with 5 to 7 versus 0 to 1 ideal LS7 factors were 0.55 (0.39, 0.76) and 1.00 (0.98, 1.02), respectively. Among participants with 0 to 1 and 5 to 7 ideal LS7 factors, mean inpatient expenditures were $3995 and $1250, respectively, mean outpatient expenditures were $5166 and $2853, respectively, and mean total expenditures were $9147 and $4111, respectively. After multivariable adjustment, the mean (95% CI) cost difference comparing participants with 5 to 7 versus 0 to 1 ideal LS7 factors was -$2551 (-$3667, -$1435) for inpatient, -$2410 (-$3089, -$1731) for outpatient, and -$5016 (-$6577, -$3454) for total expenditures.CONCLUSIONS: Better cardiovascular health is associated with lower risk for inpatient encounters and lower inpatient and outpatient healthcare expenditures.

DOI10.1161/JAHA.116.005106
Alternate JournalJ Am Heart Assoc
PubMed ID28151403
PubMed Central IDPMC5523785
Grant ListR01 HL080477 / HL / NHLBI NIH HHS / United States
U01 NS041588 / NS / NINDS NIH HHS / United States
K24 HL111154 / HL / NHLBI NIH HHS / United States
K07 AG043588 / AG / NIA NIH HHS / United States