CHAPEL HILL - Regular gardening, walking or swimming and simple changes in the home could significantly reduce health-related expenses for older Americans and the federal government, a new University of North Carolina at Chapel Hill study suggests.
Dr. Sally C. Stearns, associate professor of health policy and administration at the UNC-CH School of Public Health, and colleagues conducted the study.
"We found that certain activities were associated with a 5 to 10 percent reduction in average monthly Medicare expenditures," Stearns said. "Monthly expenditures were 7.4 percent less at 12 months among people who swam or walked regularly vs. those who did not and 8.4 percent less at 48 months."
Regular gardeners saw a 5.6 percent reduction in such costs, she said.
A report on the findings appears in the October issue of the American Journal of Public Health.
Besides Stearns, UNC-CH authors are Dr. Shulamit L. Bernard, Sarah B. Fasick, Robert Schwartz, Dr. Robert Kondrad and Dr. Gordon DeFriese, director of the Cecil G. Sheps Center for Health Services Research. Dr. Marcia G. Ory of the National Institute on Aging also helped with the work.
The group undertook the study to learn whether simple, everyday activities designed to improve health and functioning could cut health-care costs, Stearns said. It involved analyzing data from 2,921 U.S. residents who were part of a nationally representative survey of people over age 65 -- the National Survey of Self-Care and Aging. Researchers also analyzed Medicare claims data at 12 and 48 months after the initial survey.
Making homes safer by using non-skid rugs, installing hand rails in bathrooms and making other modest changes resulted in a 10 percent monthly reduction in Medicare costs after a year, researchers found. Personal medical monitoring of blood pressure, urine and other health signs caused a 4.3 percent drop after 48 months.
"In contrast to these encouraging results, we also found that average monthly expenditures increased by roughly 15 percent during the 12-month follow-up for people who indicated that they had quit smoking when compared with people who had never smoked," Stearns said. "This may be due to our inability to control for the length of time since the decision to quit and the fact that some people may have suffered substantial health impairment prior to quitting."
One limitation of the study was that it was not randomized or as rigorously controlled as some research projects are. Also, investigators could not determine whether people who engaged in such health-oriented activities were inherently different from those who did not, she said.
Strengths included being able to control for numerous personal characteristics and measures of health such as smoking and major illnesses and the four-year follow-up period.
"Our study provides evidence of potential reductions in health care expenditures from simple self-care activities, but caution should be used in interpreting the results," Stearns said. "While the observed reductions of 5 to 10 percent are encouraging, the relationships are not necessarily causal."
Several factors were unexpectedly associated with higher expenditures, and so more detailed research is needed, she said. In the meantime, the evidence is encouraging and suggests that people who actively seek to improve their health will be healthier in the long run and incur fewer medical expenses later in life.
Note: Stearns, who is on leave at the University of Aberdeen, can be reached at 44-1224-552494 or via e-mail at scs2@heru.abdn.ac.uk. Konrad and DeFriese's number is (919) 966-5011.
Contact: David Williamson, (919) 962-8596.
Journal
American Journal of Public Health