Participation in fitness-related activities of an incentive-based health promotion program and hospital costs: a retrospective longitudinal study

Patel, Deepak, Lambert, Estelle V., da Silva, Roseanne, Greyling, Mike, Kolbe-Alexander, Tracy, Noach, Adam, Conradie, Jaco, Nossel, Craig, Borresen, Jill and Gaziano, Thomas (2011) Participation in fitness-related activities of an incentive-based health promotion program and hospital costs: a retrospective longitudinal study. American Journal of Health Promotion, 25 5: 341-348. doi:10.4278/ajhp.100603-QUAN-172


Author Patel, Deepak
Lambert, Estelle V.
da Silva, Roseanne
Greyling, Mike
Kolbe-Alexander, Tracy
Noach, Adam
Conradie, Jaco
Nossel, Craig
Borresen, Jill
Gaziano, Thomas
Title Participation in fitness-related activities of an incentive-based health promotion program and hospital costs: a retrospective longitudinal study
Journal name American Journal of Health Promotion   Check publisher's open access policy
ISSN 0890-1171
2168-6602
Publication date 2011
Sub-type Article (original research)
DOI 10.4278/ajhp.100603-QUAN-172
Open Access Status
Volume 25
Issue 5
Start page 341
End page 348
Total pages 8
Place of publication Troy, MI, United States
Publisher American Journal of Health Promotion
Language eng
Formatted abstract
Purpose: A retrospective, longitudinal study examined changes in participation in fitness-related activities and hospital claims over 5 years amongst members of an incentivized health promotion program offered by a private health insurer.

Design: A 3-year retrospective observational analysis measuring gym visits and participation in documented fitness-related activities, probability of hospital admission, and associated costs of admission.

Setting: A South African private health plan, Discovery Health and the Vitality health promotion program.

Participants: 304,054 adult members of the Discovery medical plan, 192,467 of whom registered for the health promotion program and 111,587 members who were not on the program. Intervention. Members were incentivised for fitness-related activities on the basis of the frequency of gym visits.

Measures: Changes in electronically documented gym visits and registered participation in fitness-related activities over 3 years and measures of association between changes in participation (years 1-3) and subsequent probability and costs of hospital admission (years 4-5). Hospital admissions and associated costs are based on claims extracted from the health insurer database.

Analysis: The probability of a claim modeled by using linear logistic regression and costs of claims examined by using general linear models. Propensity scores were estimated and included age, gender, registration for chronic disease benefits, plan type, and the presence of a claim during the transition period, and these were used as covariates in the final model.

Results: There was a significant decrease in the prevalence of inactive members (76% to 68%) over 5 years. Members who remained highly active (years 1-3) had a lower probability (p < .05) of hospital admission in years 4 to 5 (20.7%) compared with those who remained inactive (22.2%). The odds of admission were 13% lower for two additional gym visits per week (odds ratio, .87; 95% confidence interval [CI], .801-.949).

Conclusion: We observed an increase in fitness-related activities over time amongst members of this incentivebased health promotion program, which was associated with a lower probability of hospital admission and lower hospital costs in the subsequent 2 years.
Keyword Chronic Disease
Health Insurance
Prevention Research
Wellness Program
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Human Movement and Nutrition Sciences Publications
 
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