Abstract P285: Potential Direct Medical Cost-Savings Attributable to Physical Activity in Major Disease Categories

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Zachary Rourk ◽  
Ivo Abraham ◽  
Thomas Olson ◽  
Eric Snyder
Keyword(s):  
Physical Activity ◽  
Direct Medical Cost ◽  
Medical Cost ◽  
Population Attributable Risk ◽  
Cost Savings ◽  
Cost Effective ◽  
The United States ◽  
Medical Intervention ◽  
Physically Active ◽  
Meta Analyses

Introduction: Physical activity (PA) is known to be effective in treating and preventing many lifestyle diseases including CVD, stroke, depression, type II diabetes, Alzheimer’s disease, as well as breast and colon cancer. To date the direct medical cost-savings of PA as a medical intervention are poorly understood. Hypothesis: We hypothesized that a 10% increase in the proportion of US citizens who meet the minimum weekly exercise requirements of 150 minutes per week would lead to savings in direct medical costs (DMC) and cases prevented, as related to the above diseases. Methods: Population Attributable Risk (PAR) was calculated as PAR= (1+Prf x (RR-1))/(Prf x(RR-1)), where Prf is the percentage of the U.S. population not meeting minimum exercise requirements and RR is the relative risk of disease for sedentary versus physically active individuals. Prf and RR data were retrieved from the most recent and comprehensive meta-analyses and systematic reviews. PAR was calculated for each disease under two conditions; first, Prf was equal to the current percent (9.6%) of the population estimated to achieve the minimum weekly PA requirements. Second, Prf was equal to the initial Prf plus 10 percent (19.6%). For each condition the following were calculated: Attributable DMC=(PAR x DMC), preventable cases=(PAR x Prevalence) and Savings=(Condition 2- Condition 1). Results: The Prevalence, RR, PAR and DMC are provided in Table 1. This table also describes the potential savings in DMC and new cases by improving the Prf by 10%. A 10% increase in US citizens who meet the minimum weekly exercise requirements could lead to a total savings of 10.78 billion USD in DMC and 2.1 million cases prevented related to the studied diseases. Conclusion: A healthcare system directed PA intervention that effectively leads to a 10% increase in US citizens that meet minimum weekly exercise requirements and costs less than 10.78 billion dollars has the potential to be cost-effective, and prevent and treat, millions of cases in the United States.

scholarly journals Cardiovascular Healthcare Cost Savings Associated with Increased Whole Grains Consumption among Adults in the United States

Nutrients ◽  
2020 ◽  
Vol 12 (8) ◽  
pp. 2323
Author(s):  
Mary M. Murphy ◽  
Jordana K. Schmier
Keyword(s):  
Health Economic ◽  
Direct Medical Cost ◽  
Healthcare Cost ◽  
Medical Cost ◽  
Cost Savings ◽  
The United States ◽  
Whole Grains ◽  
Dietary Guidelines ◽  
Potential Health ◽  
One Year

Little is known about the potential health economic impact of increasing the proportion of total grains consumed as whole grains to align with Dietary Guidelines for Americans (DGA) recommendations. Health economic analysis estimating difference in costs developed using (1) relative risk (RR) estimates between whole grains consumption and outcomes of cardiovascular disease (CVD) and a selected component (coronary heart disease, CHD); (2) estimates of total and whole grains consumption among US adults; and (3) annual direct and indirect medical costs associated with CVD. Using reported RR estimates and assuming a linear relationship, risk reductions per serving of whole grains were calculated and cost savings were estimated from proportional reductions by health outcome. With a 4% reduction in CVD incidence per serving and a daily increase of 2.24 oz-eq of whole grains, one-year direct medical cost savings were estimated at US$21.9 billion (B) (range, US$5.5B to US$38.4B). With this same increase in whole grains and a 5% reduction in CHD incidence per serving, one-year direct medical cost savings were estimated at US$14.0B (US$8.4B to US$22.4B). A modest increase in whole grains of 0.25 oz-eq per day was associated with one-year CVD-related savings of $2.4B (US$0.6B to US$4.3B) and CHD-related savings of US$1.6B (US$0.9B to US$2.5B). Increasing whole grains consumption among US adults to align more closely with DGA recommendations has the potential for substantial healthcare cost savings.

Association of Behavioral Phenotypes With Changes in Sleep During a Workplace Wellness Program

2021 ◽  
pp. 089011712110150
Author(s):  
Kimberly J. Waddell ◽  
Sujatha Changolkar ◽  
Gregory Szwartz ◽  
Sarah Godby ◽  
Mitesh S. Patel
Keyword(s):  
Physical Activity ◽  
Sleep Duration ◽  
Physical Activity Intervention ◽  
Secondary Analysis ◽  
The United States ◽  
Behavioral Phenotype ◽  
Workplace Wellness ◽  
Wellness Program ◽  
Behavioral Phenotypes ◽  
Physically Active

Purpose: Examine changes in sleep duration by 3 behavioral phenotypes during a workplace wellness program with overweight and obese adults. Design: Secondary analysis of a randomized clinical trial Setting: Remotely monitored intervention conducted across the United States Subjects: 553 participants with a body mass index ≥25 Intervention: Participants were randomized to 1 of 4 study arms: control, gamification with support, gamification with collaboration, and gamification with competition to increase their physical activity. All participants were issued a wrist-worn wearable device to record their daily physical activity and sleep duration. Measures: The primary outcome was change in daily sleep duration from baseline during the 24 week intervention and follow-up period by study arm within behavioral phenotype class. Analysis: Linear mixed effects regression. Results: Participants who had a phenotype of less physically active and less social at baseline, in the gamification with collaboration arm, significantly increased their sleep duration during the intervention period (30.2 minutes [95% CI 6.9, 53.5], P = 0.01), compared to the control arm. There were no changes in sleep duration among participants who were more extroverted and motivated or participants who were less motivated and at-risk. Conclusions: Changes in sleep during a physical activity intervention varied by behavioral phenotype. Behavioral phenotypes may help to precisely identify who is likely to improve sleep duration during a physical activity intervention.

scholarly journals Surgical instrumentation: the true cost of instrument trays and a potential strategy for optimization

2015 ◽  
Vol 4 (6) ◽  
pp. 82 ◽  
Author(s):  
Julie M. Mhlaba ◽  
Emily W. Stockert ◽  
Martin Coronel ◽  
Alexander J. Langerman
Keyword(s):  
United States ◽  
Cost Savings ◽  
Cost Effective ◽  
The United States ◽  
Waste Reduction ◽  
Significant Cost ◽  
Instrument Type ◽  
Hospital Revenue ◽  
Potential Strategy ◽  
The Cost

Objective: Operating rooms (OR) generate a large portion of hospital revenue and waste. Consequently, improving efficiency and reducing waste is a high priority. Our objective was to quantify waste associated with opened but unused instruments from trays and to compare this with the cost of individually wrapping instruments.Methods: Data was collected from June to November of 2013 in a 550-bed hospital in the United States. We recorded the instrument usage of two commonly-used trays for ten cases each. The time to decontaminate and reassemble instrument trays and peel packs was measured, and the cost to reprocess one instrument was calculated.Results: Average utilization was 14% for the Plastic Soft Tissue Tray and 29% for the Major Laparotomy Tray. Of 98 instruments in the Plastics tray (n = 10), 0% was used in all cases observed and 59% were used in no observed cases. Of 110 instruments in the Major Tray (n = 10), 0% was used in all cases observed and 25% were used in no observed cases. Average cost to reprocess one instrument was $0.34-$0.47 in a tray and $0.81-$0.84 in a peel pack, or individually-wrapped instrument.Conclusions: We estimate that the cost of peel packing an instrument is roughly two times the cost of tray packing. Therefore, it becomes more cost effective from a processing standpoint to package an instrument in a peel pack when there is less than a 42%-56% probability of use depending on instrument type. This study demonstrates an opportunity for reorganization of instrument delivery that could result in a significant cost-savings and waste reduction.

scholarly journals High Costs of Dialysis Transportation in the United States: Exploring Approaches to a More Cost-effective Delivery System

10.36469/9861 ◽  
2013 ◽  
Vol 1 (2) ◽  
pp. 134-150 ◽  
Author(s):  
J. Mark Stephens ◽  
Samuel Brotherton ◽  
Stephan C. Dunning ◽  
Larry C. Emerson ◽  
David T. Gilbertson ◽  
...  
Keyword(s):  
United States ◽  
Public Transportation ◽  
Cost Savings ◽  
Cost Effective ◽  
The United States ◽  
Levels Of Care ◽  
Dialysis Facility ◽  
Effective Delivery ◽  
Stage Renal Disease ◽  
End Stage

Background: The costs of transporting end-stage renal disease (ESRD) patients to dialysis centers are high and growing rapidly. Research has suggested that substantial cost savings could be achieved if medically appropriate transport was made available and covered by Medicare. Objectives: To estimate US dialysis transportation costs from a purchaser’s perspective, and to estimate cost savings that could be achieved if less expensive means of transport were utilized. Methods: Costs were estimated using an actuarial model. Travel distance estimates were calculated using GIS software from patient ZIP codes and dialysis facility addresses. Cost and utilization estimates were derived from fee schedules, government reports, transportation websites and peer-reviewed literature. Results: The estimated annual cost of dialysis transportation in the United States is $3.0 billion, half of which is for ambulances. Most other costs are due to transport via ambulettes, wheelchair vans and taxis. Approximately 5% of costs incurred are for private vehicle or public transportation use. If ambulance use dropped to 1% of trips from the current 5%, costs could be reduced by one-third. Conclusions: Decision-makers should consider policies to reduce ambulance use, while providing appropriate levels of care.

scholarly journals SLEEP QUALITY AS A MECHANISM LINKING PHYSICAL ACTIVITY AND COGNITIVE FUNCTIONING

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S779-S779
Author(s):  
Alycia N Bisson ◽  
Margie E Lachman
Keyword(s):  
Physical Activity ◽  
Executive Functioning ◽  
Sleep Quality ◽  
The United States ◽  
Physically Active ◽  
Waking Up ◽  
The Relationship ◽  
Second Wave ◽  
Moderating Role

Abstract Modifiable health behaviors, such as physical activity and sleep quality are important for cognition throughout life. A growing body of research also suggests that engaging in enough physical activity is important to sleeping well. One recent study found that sleep efficiency mediates the relationship between physical activity and cognition. It is still unknown whether other metrics of sleep quality are mediators. The present study tested mediation in the second wave of the Midlife in the United States (MIDUS) study. Using the PROCESS macro for SPSS, we found that those who were more physically active fell asleep faster, and had better executive functioning. In addition, those who were more physically active reported waking up fewer times during the night, and had better executive functioning and self-rated memory. Discussion will focus on the moderating role of gender and distinctions between findings with different measures of sleep, physical activity, and cognition.

Steel Bridges with Double-Composite Action: Innovative Design

2000 ◽  
Vol 1696 (1) ◽  
pp. 299-309 ◽  
Author(s):  
Steven L. Stroh ◽  
Rajan Sen
Keyword(s):  
Cost Savings ◽  
Cost Effective ◽  
The United States ◽  
South Florida ◽  
Steel Bridge ◽  
Innovative Design ◽  
Composite Action ◽  
Design Concepts ◽  
Negative Moment ◽  
Composite Bridge

Bridge engineers are continually faced with the challenge of providing efficient and cost-effective structures. In particular, the Florida Department of Transportation has recognized the need to develop economical bridge configurations in the medium-span range of 200- to 400-ft (60.96-to 121.92-m) spans and authorized a research project at the University of South Florida to identify and develop innovative design concepts within this span range. The study identified the concept of a steel bridge with double-composite action as an innovative bridge concept with the potential for significant cost savings compared with conventional modes of construction. This bridge type has been used with good success in Europe, but to the authors’ knowledge it has not been used in the United States. In addition to a composite concrete top slab, the double-composite bridge concept utilizes a composite concrete bottom slab in the negative moment regions. The result is provision of a design meeting compact requirements throughout, increased stiffness with corresponding decrease in fatigue stress range and deflections, savings in cross frames, and savings in flange material. The design implications of this system are examined, including redistribution effects due to creep and shrinkage, implications of different construction sequences, and strength and serviceability issues. Trial designs are presented, including both plate and box girder type structures, and design considerations are discussed. A prototype structure is identified for further development of the double-composite concept.

Physical Activity and Psychosocial Discomfort among High School Students in Taipei, Taiwan

2003 ◽  
Vol 22 (3) ◽  
pp. 215-228 ◽  
Author(s):  
Randy M. Page ◽  
Ching-Mei Lee ◽  
Nae-Fang Miao ◽  
Kirk Dearden ◽  
Athena Carolan
Keyword(s):  
Physical Activity ◽  
High School ◽  
High School Students ◽  
Vigorous Physical Activity ◽  
Asian Country ◽  
The United States ◽  
School Students ◽  
Physically Active ◽  
National Differences ◽  
The Relationship

The relationship between physical activity and psychosocial discomfort was investigated among a sample of 2,665 high school students in Taipei, Taiwan. Results showed that both boys and girls who were physically inactive or engaged in infrequent physical activity scored higher than their more physically active counterparts on three measures of psychosocial discomfort—loneliness, shyness, and hopelessness. Results also showed that a high proportion of Taipei City and Taipei County high school students did not report frequent participation in vigorous physical activity and strengthening exercises. This study's findings are discussed in the context of implications for health education programs aimed at increasing physical activity in youth. Additionally, this study explores cross-national differences in loneliness, shyness, and hoplessness between this sample of adolescents and samples of adolescents in the United States and another Asian country.

scholarly journals Physically Active Lessons Meta-Analysis - Norris et al. POST-PRINT

2019 ◽  
Author(s):  
Emma Norris ◽  
Tommy van Steen ◽  
Artur Direito ◽  
Emmanuel Stamatakis
Keyword(s):  
Physical Activity ◽  
Systematic Review ◽  
Health Outcomes ◽  
Educational Outcomes ◽  
Meta Analysis ◽  
Grey Literature ◽  
Risk Of Bias ◽  
Control Group ◽  
Physically Active ◽  
Meta Analyses

Objective: This review provides the first meta-analysis of the effects of physically active lessons on lesson-time and overall physical activity (PA), as well as health, cognition and educational outcomes. Design: Systematic review and meta-analysis. Six meta-analyses pooled effects on lesson-time PA, overall PA, in-class educational and overall educational outcomes, cognition and health outcomes. Meta-analyses were conducted using the metafor package in R. Risk of bias was assessed using the Cochrane tool for risk of bias. Data sources: PubMed, Embase, PsycINFO, ERIC and Web of Science, grey literature and reference lists were searched in December 2017 and April 2019. Studies eligibility criteria: Physically active lessons compared to a control group in a randomised or non-randomised design, within single component interventions in general school populations. Results: 42 studies (39 in preschool or elementary school settings, 27 randomised controlled trials) were eligible for inclusion in the systematic review and 37 of them were included across the six meta-analyses (n=12,663). Physically active lessons were found to produce large, significant increases in lesson-time PA (d=2.33; 95%CI 1.42, 3.25: k=16) and small, significant effects on overall PA (d= 0.32, 95%CI 0.18, 0.46: k=8). A large, significant effect was shown on lesson-time educational outcomes (d=0.81; 95%CI 0.47, 1.14: k=7) and a small, significant effect on overall educational outcomes (d=0.36, 95%CI [0.09, 0.63], k=25). No effects were seen on cognitive (k=3) or health outcomes (k=3). 25/42 studies had high risk of bias in at least 2 domains. Conclusion: In elementary and preschool settings, when physically active lessons were added into the curriculum they had a positive impact on both physical activity and educational outcomes. These findings support policy initiatives encouraging the incorporation of physically active lessons into teaching in elementary and preschool settings.

scholarly journals Diet, weight status, and physical activity in cancer prevention

2020 ◽  
Vol 4 (08) ◽  
pp. 325-335
Author(s):  
Slimane Mehdad ◽  
Saida Mansour ◽  
Hassan Aguenaou ◽  
Khalid Taghzouti
Keyword(s):  
Physical Activity ◽  
Cancer Prevention ◽  
Weight Status ◽  
Tumor Development ◽  
Healthy Weight ◽  
Physically Active ◽  
Processed Meats ◽  
Balanced Diet ◽  
Increased Risk ◽  
Meta Analyses

Background: Cancer is a multifactorial disease involving individual, behavioral and environmental factors that can contribute to its onset. More than 40% of cancers are estimated to be attributable to avoidable risk factors, particularly diet, physical activity, weight status, and alcohol consumption. Aim: To provide insight into the role of weight status, diet, and physical activity in cancer causation and prevention, and to highlight evidence-based recommendations. Material and methods: A literature review of published studies, particularly recent systematic reviews, meta-analyses, and large prospective studies was conducted using PubMed/Medline, ScienceDirect, and Google Scholar databases. Results: There is evidence that diets high in red and processed meats, fat and refined carbohydrates, and low in plant foods such as vegetables, fruits, and whole grains, high consumption of alcohol, overweight/obesity, and physical inactivity are associated with increased risk of tumor development and progression. Therefore, the current recommendations for cancer prevention are based on: (1) eating at least five portions (400g) of vegetables (3 portions) and fruits (2 portions); (2) limiting the consumption of alcohol and unhealthy foods such as red and processed meats, energy-dense foods, and trans-fatty acids; (3) maintaining a healthy weight status; and (4) being at least moderately physically active. Conclusion: While a balanced diet, as defined by the recommendations, can help reduce the risk of certain cancers, no single food can prevent the development of this pathology. The term "anticancer" associated with diet is therefore misleading. Several nutritional factors are associated with an increase or a decrease in the risk of certain cancers. Adopting a healthy and plant-based diets, avoiding overweight/obesity, and being physically active are considered as cornerstones of preventive strategies against cancer. Further studies are needed to elucidate the associations between dietary and lifestyle patterns and cancer. Keywords: Cancer, Diet, Weight status, Overweight, Obesity, Physical activity.

scholarly journals Cost-Effective Use of White Blood Cell Growth Factors in the Veterans Administration

Blood ◽  
2018 ◽  
Vol 132 (Supplement 1) ◽  
pp. 4761-4761
Author(s):  
Kevin Knopf ◽  
William Hrureshky ◽  
Bryan Love ◽  
Leann Norris ◽  
Charles L. Bennett
Keyword(s):  
United States ◽  
Survey Data ◽  
Conflicts Of Interest ◽  
Cost Savings ◽  
Cost Effective ◽  
The United States ◽  
Convincing Evidence ◽  
Cost Driver ◽  
Veterans Administration ◽  
Va Health Care System

Abstract The use of granulocyte colony-stimulating (G-CSF) factors to avoid chemotherapy induced neutropenia is a major cost driver in clinical oncology. Short acting formulations, while less convenient, are 39% the cost of the longer formulation (Pegfilgrastim). We analyzed the use of G-CSF vs. Neulasta in the Veterans Administration (VA) health care system as currently practiced by clinical judgement and analyzed this economically. A survey of 23 sites within the VA on the relative frequency of use of filgrastim, Tbo-filgrastim, Filgrastim-sndz and Pegfilgrastim was conducted. Cost was estimated using 340B pricing. A maximally cost-effecient strategy of 100% Tbo-filgrastim would result in a cost of $62,336 per 100 patient episodes. Tbo-filgrastim was the preferred treatment in 18 of 23 sites surveyed. Cost results ranged from a minimum of $62,336 (4 of 23 sites) to a maximum of $201,356 (2 of 23 sites) with a mean cost of $99,080. The VA was overall 73% efficient, and therefore highly cost-effective, in minimizing use of Pegfilgrasim. As in Europe cost-efficiency favors the use of Tbo-filgrastim over Pegfilgrastim; further cost-saving opportunities exist with the following strategies : (1) avoid G-CSF use where there is no convincing evidence of efficacy (i.e. low risk patients, treatment of neutropenia rather than prophylaxis) (2) use daily filgrastim in lieu of pegfilgrastim whenever possible (3) use Tbo-filgrastrim rather than filgrastrimn (4) continue to examine strategies using 2 or 4 day courses of G-CSf as opposed to 8 days which would cut cost an additional 50 to 75%. Survey data showed that uptake of biosimilar G-CSF in the VA system has been extremely rapid. All sites are using biosimilar GCSF for all new patients; 6 of 23 sites were comfortable shifting current patients on branded G-CSF to the biosimilar. Survey data shows an overwhelming use of filgrastrim compared to pegfilgrastim in the VA system, in contradistinction to the rest of the United States - resulting in an efficiency of 73% (i.e. only 27% of patients are being given pegfilgrastrim). This represents a great savings to the VA system which can be emulated in other sites in the United States. Switching to a Tbo-filgrastim, although heralded by some as cost savings, only engendered a cost savings of 2.2% - small compared to other clinical changes. Disclosures No relevant conflicts of interest to declare.

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