Health Care Use and Costs Associated With Use of a Health Club Membership Benefit in Older Adults with Diabetes
- Huong Q. Nguyen, PHD1,
- Matthew L. Maciejewski, PHD2,
- Sue Gao, PHD3,
- Elizabeth Lin, MD, MPH4,
- Barbara Williams, PHD5 and
- James P. LoGerfo, MD, MPH6
- 1Department of Biobehavioral Nursing and Health Systems, University of Washington, Seattle, Washington
- 2Center for Health Services Research in Primary Care, Durham VA Medical Center, Durham, North Carolina, and the Division of Pharmaceutical Outcomes and Policy, School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
- 3Global Health Economics, Amgen Inc., Thousand Oaks, California
- 4Center for Health Studies, Group Health Cooperative, Seattle, Washington
- 5Health Promotion Research Center, University of Washington, Seattle, Washington
- 6Department of Health Services, Global Health and Health Promotion Research Center, University of Washington, Seattle, Washington
- Corresponding author: Huong Q. Nguyen, hqn{at}u.washington.edu
Abstract
OBJECTIVE—The purpose of this study was to determine whether elective use of a health plan–sponsored health club membership had an impact on health care use and costs among older adults with diabetes.
RESEARCH DESIGN AND METHODS—Administrative claims for 2,031 older adults with diabetes enrolled in a Medicare Advantage plan were obtained for this retrospective cohort study. Participants (n = 618) in the plan-sponsored health club benefit (Silver Sneakers [SS]) and control subjects (n = 1,413) matched on SS enrollment index date were enrolled in the plan for at least 1 year before the index date. Two-year health care use and costs of SS participants and control subjects were estimated in regressions adjusting for baseline differences.
RESULTS—SS participants were more likely to be male, had a lower chronic disease burden, used more preventive services, and had a lower prevalence of arthritis (P ≤ 05). SS participants had lower adjusted total health care costs than control subjects in the first year after enrollment (−$1,633 [95% CI −$2,620 to −$646], P = 0.001), and adjusted total costs in year 2 trended lower (−$1,230 [−$2,494 to $33], P = 0.06). Participants who made on average ≥2 SS visits/week in year 1 had lower total costs in year 2 ($2,141 [−$3,877 to −$405], P = 0.02) than participants who made <2 visits/week.
CONCLUSIONS—Use of a health club benefit by older adults with diabetes was associated with slower growth in total health care costs over 2 years; greater use of the benefit was actually associated with declines in total costs.
Footnotes
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Published ahead of print at http://care.diabetesjournals.org on 5 May 2008.
The contents of the report are solely the responsibility of the authors and do not necessarily represent the official view of the Centers for Disease Control and Prevention or the National Institutes of Health.
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- Received March 27, 2008.
- Accepted April 25, 2008.
- DIABETES CARE
