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Modifiable health-related factors (smoking, physical activity and body mass index) and health care use and costs among adult cancer survivors.

Abstract：

OBJECTIVE:To examine the associations between modifiable health-related factors, such as smoking, low physical activity and higher body mass index (BMI), and annual health care visits and expenditures among adult cancer survivors in the United States. METHODS:Using data from the 2010-2014 Medical Expenditures Panel Survey, we identified 4920 cancer survivors (aged 18-64 years) and a matched comparison group. Our outcomes were number of annual health care visits [i.e., outpatient/office-based, hospital discharges and emergency department (ED) visits] and total health care expenditures. We examined health-related factors, demographics, insurance and health status (i.e., comorbidity and mental distress). Bivariate and multivariable analyses examined the associations between outcomes and health-related factors. RESULTS:Of survivors, approximately 21% were current smokers, 52% reported low physical activity and 35% were obese, vs. 19.6, 49.5 and 36.7%, respectively, of the comparison group. These factors were associated with greater comorbidity and mental distress in both groups. Current smokers among survivors were less likely to have outpatient visits [marginal effect on the number of visits (ME) = -3.44, 95% confidence interval (CI) -5.02 to -1.86, P < 0.001] but more likely to have ED visits (ME = 0.11, 95% CI 0.05-0.18, P = 0.001) than non-smokers. Physically active individuals in both groups had fewer ED visits, and lower total expenditures than those who reported low physical activity. CONCLUSION:Regular assessments of health-related factors should be incorporated in survivorship care to reduce the burden of cancer. Modification of survivors' health-related factors (e.g., low physical activity) may help improve their health outcomes and reduce financial burden.

journal_name

J Cancer Res Clin Oncol

journal_title

Journal of cancer research and clinical oncology

authors

Kaul S,Avila JC,Jupiter D,Rodriguez AM,Kirchhoff AC,Kuo YF

doi

10.1007/s00432-017-2494-3

subject

Has Abstract

pub_date

2017-12-01 00:00:00

pages

2469-2480

issue

eissn

0171-5216

issn

1432-1335

pii

10.1007/s00432-017-2494-3

journal_volume

143

pub_type

杂志文章

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Modifiable health-related factors (smoking, physical activity and body mass index) and health care use and costs among adult cancer survivors.