Abstract 19891: Physical Activity Makes a Difference: Out-of-Pocket Health Care Expenditure and Quality-of-Life in Patients with Primary Hypertension
Background: Regular physical activity is a guideline-recommended component of disease management in patients with hypertension (HTN). Purpose: To examine the associations of out-of-pocket health care expenditure and quality-of-life (QOL) with physical activity in this population.
Methods: A nationally-representative sample from the 2006 Agency for Healthcare Research and Quality Medical Expenditure Panel Survey was used for this study of adults (18 years or older) with a diagnosis of primary HTN (ICD-9:401.x). Generalized linear modeling (gamma family / log link) was used to assess all-cause out-of-pocket health care expenses and QOL (SF-12v2 physical and mental component scores) as a function of physical inactivity (self-report of not spending ≥30 minutes in moderate physical activity ≥3 times per week). National population estimates were adjusted for demographics (age, gender, race, education, marital-status, income, region), payer (% coverage by public and/or private insurance), comorbidity severity (Deyo-Charlson index), complicating conditions (depression, diabetes, myocardial infarction, cerebrovascular accidents, heart failure, peripheral vascular disease), limitations to physical functioning, and anti-HTN treatment (classes).
Results: (reported as weighted estimates±standard errors): Mean age (n=46,884,259) was 60.8±0.3 years and 54.9%±0.8% were female; 23.4±0.7% had diabetes, and 13.9±0.5% had depression. 52.8±0.9% of the sample reported being physically inactive. On average, patients had $1,453±47 in out-of-pocket health care expenses; average physical and mental QOL scores were 42.4±0.2 and 50.2±0.1 respectively. Physical inactivity was associated with 14.9±5.2% greater out-of-pocket health care expenses, 7.4%±0.8% lower physical QOL, and 3.3%±0.7% lower mental QOL (all P<.0001).
Conclusion: Controlling for limitations to physical functioning and other pertinent factors, we found strong associations between physical inactivity and outcomes that matter to patients with HTN (out-of-pocket expenses and QOL). Further research is needed to identify amenable barriers to physical activity and promote physical activity as a potential means of improving patient-oriented outcomes in persons with HTN.
- © 2010 by American Heart Association, Inc.