日本仙台鹤谷地区70岁以上老年人运动量与医疗费用的相关性研究

Research on the association between physical activity volume and medical care cost in a community-based elderly population aged 70 years and over in Japan

目的探讨日本仙台鹤谷地区70岁以上老年人不同运动量与医疗费用之间的关系。方法以日本仙台鹤谷地区70岁以上缴纳国民医疗保险的494名老年人为调查对象，通过现场问卷调查对不同运动量与医疗费用的关系进行分析。结果通过25个月对医疗费用的前瞻性研究发现，在运动时间一定的情况下，Ⅰ级运动量组平均每人每个月所消耗的住院医疗费、住院天数、门诊医疗费、门诊次数及总医疗费分别为（196．7±72．1）美元、（0．7±0．3）d、（308．7±54．4）美元、（6．2±1．1）次、（506．9±94．2）美元；Ⅱ级运动量组分别为（139．8±72．1）美元、（0．5±0．3）d、（295．3±54．6）美元、（6．1±1．1）次、（437．8±94．5）美元；Ⅲ级运动量组分别为（134．1±72．5）美元、（0．4±0．3）d、（278．8±54．9）美元、（5．8±1．1）次、（418．1±95．0）美元，3组老年人随运动量的不同，住院医疗费及总医疗费差异有统计学意义（F=5．85、8．11，均P=0．01）。结论在运动时间一定的条件下，维持相对较高运动量与低医疗费有很高的相关性。

Objective To investigate the association between physical activity volume and medical care cost in elderly persons aged 70 years and over in Crane Valley, Sendai, Japan. Methods A total of 494 community-dwelling Japanese elderly persons living in residential area of Sendai City in northern Japan completed a self-administered questionnaire that included questions on physical activity. We ascertained total medical care costs through computerized linkage with claims lodged between November 2002 and December 2004 from the Miyagi National Health Insurance Association. Results After multivariate adjustment for potential confounders, the average monthly medical costs of hospitalization, hospital days, outpatient medical expenses, out-patient numbers and the total medical expenses in grade Ⅰ exercise volume group were （196.7±72. 1） U.S. dollars, （0.7±0.3） d, （308. 7±54. 4） U.S. dollars, （6.2± 1.1） times and （506.9±94.2） U.S. dollars; in grade Ⅱ exercise volume group were （139.8±72.1） U.S. dollars, （0. 5±0.3） d, （295.3±54.6） U.S. dollars, （6.1±1.1） times and （437. 8±94.5） U.S. dollars; in grade Ⅲ exercise volume group were （134. 1±72.5） U.S. dollars, （0.4±0.3） d, （278.8±54.9） U.S. dollars, （5.8±1.1） times and （418. 1±95.0） U.S. dollars. With the increase in physical activity, there were significant differences between the medical costs of hospitalization and total medical expenses （F=5.85 and 8.11, both P= 0. 01）. Conclusions This prospective study indicates that a higher volume of physical activity is associated with lower medical care costs among Japanese elderly persons.