Abstract 06: Higher Fitness is Associated with Lower Heath Care Costs: The Veterans Exercise Testing Study
Introduction: The association between poor physical fitness and adverse health outcomes is well-established, but few data are available regarding the association between fitness and health care costs.
Hypothesis: We assessed the hypothesis that higher fitness is associated with lower overall health care costs.
Methods: We studied 9,945 patients (mean 58±11 years) who underwent maximal exercise testing for clinical reasons at two VA hospitals as part of the Veterans Exercise Testing Study (VETS). Fitness was expressed as the percentage of age-predicted peak METs achieved and categorized in quartiles. Total and annualized health care costs, derived from the VA Allocated Resource Center, were assessed between 2006 and 2013. Health care costs between quartiles of fitness were compared using ANOVA; multiple regression was used to determine clinical and exercise test predictors of health care costs. Follow-up for all-cause mortality (mean 8.5±5 years) was performed through March 2013.
Results: A gradient for reduced health care costs was observed with higher fitness. Expressed as annualized costs per patient (in USD x 103), subjects in the least-fit quartile had approximately 55% higher overall costs as those in the fittest quartile (Figure). Non-survivors were significantly less fit (6.5±5.1 vs. 9.1±3.5 METs, p<0.001) and exhibited roughly 3 times the health care costs of those who survived. In a multivariate model including historical, clinical and exercise test responses, fitness was a significant predictor of health care costs (p<0.001).
Conclusions: Low fitness is associated with a significant burden on the health care system. Improving fitness should be encouraged for its potential to lower health care costs.
Author Disclosures: J. Myers: None. R. Doom: None. R. King: None. H. Fonda: None. J. Abella: None. V. Froelicher: None. P. Kokkinos: None. K. Chan: None.
- © 2015 by American Heart Association, Inc.