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한국 성인의 심폐체력과 의료이용행태 및 의료비의 관련성: 국민체력100 사업 건강체력 기준을 바탕으로

Association Between Cardiorespiratory Fitness and Healthcare Costs in Adults Using the Criterion Referenced Fitness Thresholds: The Korea Institute of Sport Science Fitness Standards Study

이효진|이미현|이승희|오인환|박세정|정현경
한국운동생리학회|2021.11|운동과학 (Exercise Science)|제30권 제4호|pp. 501-509

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참고문헌

키워드

의료비Healthcare utilization심폐체력의료이용행태Aerobic capacity절대평가 기준Cardiorespiratory fitness thresholdsHealthcare costs

초록

PURPOSE: This study aimed to determine the association between cardiorespiratory fitness (CRF) and healthcare utilization and healthcare costs in Korean adults using criterion-referenced health fitness thresholds. METHODS: The sample was drawn from the Korea Institute of Sport Science Fitness Standards Study (2014–2015) participants (n=1,780) aged 19–64 years. Participants completed a treadmill exercise test in which the peak oxygen uptake was estimated from the treadmill time. CRF thresholds were identified using receiver operating characteristic curve analysis using CRF z-scores as the test and metabolic syndrome as the criterion. The participants were categorized into low-, middle-, and high-risk groups. Healthcare utilization and healthcare costs, derived from the Korea National Health Insurance Data Sharing Service, were compared using multiple linear regression with control for body mass index (BMI), income, healthcare utilization, and healthcare costs in the previous year. RESULTS: In this study, two CRF thresholds were established: one for high sensitivity, the other for high specificity. CRF thresholds at the low-risk group were 35.2–42.6 mL/kg/min for men and 26.8–34.3 mL/kg/min for women. The total healthcare costs per participant per year for the middle- and high-risk groups were 173,016 Won and 324,840 Won, respectively, higher than those in the low-risk group after the adjustment for BMI, income, healthcare utilization, and costs in the previous year (p=.006, p<.001). The high-risk group had 2.890 visits, 3.177 visit days, and 27.215 prescription days, all of which were significantly higher than those of the low-risk group (p=.003, p=.003, p=.002). CONCLUSIONS: A low CRF is associated with higher healthcare utilization and costs. Improving CRF may result in lower healthcare utilization and costs.

Abstract

PURPOSE: This study aimed to determine the association between cardiorespiratory fitness (CRF) and healthcare utilization and healthcare costs in Korean adults using criterion-referenced health fitness thresholds. METHODS: The sample was drawn from the Korea Institute of Sport Science Fitness Standards Study (2014–2015) participants (n=1,780) aged 19–64 years. Participants completed a treadmill exercise test in which the peak oxygen uptake was estimated from the treadmill time. CRF thresholds were identified using receiver operating characteristic curve analysis using CRF z-scores as the test and metabolic syndrome as the criterion. The participants were categorized into low-, middle-, and high-risk groups. Healthcare utilization and healthcare costs, derived from the Korea National Health Insurance Data Sharing Service, were compared using multiple linear regression with control for body mass index (BMI), income, healthcare utilization, and healthcare costs in the previous year. RESULTS: In this study, two CRF thresholds were established: one for high sensitivity, the other for high specificity. CRF thresholds at the low-risk group were 35.2–42.6 mL/kg/min for men and 26.8–34.3 mL/kg/min for women. The total healthcare costs per participant per year for the middle- and high-risk groups were 173,016 Won and 324,840 Won, respectively, higher than those in the low-risk group after the adjustment for BMI, income, healthcare utilization, and costs in the previous year (p=.006, p<.001). The high-risk group had 2.890 visits, 3.177 visit days, and 27.215 prescription days, all of which were significantly higher than those of the low-risk group (p=.003, p=.003, p=.002). CONCLUSIONS: A low CRF is associated with higher healthcare utilization and costs. Improving CRF may result in lower healthcare utilization and costs.

참고문헌 (40)

  1. "2019 national health insurance statistical yearbook" (2020)[URL]
  2. "2018 current status and issues of chronic disease" (2018)[URL]
  3. Piercy KL, "The physical activity guidelines for americans", JAMA, 320(19), pp.2020~2028 (2018)
  4. Carlson SA, "Inadequate physical activity and health care expenditures in the united states", Prog Cardiovasc Dis, 57(4), pp.315~323 (2015)
  5. Ding D, "The economic burden of physical inactivity : a global analysis of major non-communicable diseases", Lancet, 388(10051), pp.1311~1324 (2016)
  6. Haskell WL, "Physical activity and public health : updated recommendation for adults from the american college of sports medicine and the american heart association", Circulation, 116(9), pp.1081~1093 (2007)
  7. Carrick-Ranson G, "The effect of lifelong exercise dose on cardiovascular function during exercise", J Appl Physiol(1985), 116(7), pp.736~745 (2014)
  8. Myers J, "Physical activity and cardiorespiratory fitness as major markers of cardiovascular risk : their independent and interwoven importance to health status", Prog Cardiovasc Dis, 57(4), pp.306~314 (2015)
  9. Kodama S, "Cardiorespiratory fitness as a quantitative predictor of all-cause mortality and cardiovascular events in healthy men and women : a meta-analysis", JAMA, 301(19), pp.2024~2035 (2009)
  10. Nauman J, "Prediction of cardiovascular mortality by estimated cardiorespiratory fitness independent of traditional risk factors : the HUNT study", Mayo Clin Proc (2017), Elsevier
  11. Jiménez-Pavón D, "Cardiorespiratory fitness and risk of sudden cardiac death in men and women in the united states : a prospective evaluation from the aerobics center longitudinal study", Mayo Clin Proc (2016), Elsevier
  12. Myers J, "Cardiorespiratory fitness and reclassification of risk for incidence of heart failure : the veterans exercise testing study", Circ Heart Fail, 10(6), pp.e003780~ (2017)
  13. Kokkinos PF, "Cardiorespiratory fitness and incidence of major adverse cardiovascular events in US veterans : a cohort study", Mayo Clin Proc (2017), Elsevier
  14. Nicholl JP, "Health and health care costs and benefits of exercise", Pharmacoeconomics, 5(2), pp.109~122 (1994)
  15. Pronk NP, "Obesity, fitness, willingness to communicate and health care costs", Med Sci Sports Exerc, 31(11), pp.1535~1543 (1999)
  16. Mitchell TL, "Effects of cardiorespiratory fitness on healthcare utilization", Med Sci Sports Exerc, 36(12), pp.2088~2092 (2004)
  17. Weiss JP, "Health-care costs and exercise capacity", Chest, 126(2), pp.608~613 (2004)
  18. Bachmann JM, "Cardiorespiratory fitness in middle age and health care costs in later life", J Am Coll Cardiol, 66(17), pp.1876~1885 (2015)
  19. Kolu P, "Evaluation of the effects of physical activity, cardiorespiratory condition, and neuromuscular fitness on direct healthcare costs and sickness-related absence among nursing personnel with recurrent nonspecific low back pain", Spine, 42(11), pp.854~862 (2017)
  20. Myers J, "Association between cardiorespiratory fitness and health care costs : the veterans exercise testing study", Mayo Clin Proc (2018), Elsevier
  21. de Silva CGdS, "Association between cardiorespiratory fitness, obesity, and health care costs : the veterans exercise testing study", Int J Obes(Lond), 43(11), pp.2225~2232 (2019)
  22. Myers J, "Cardiorespiratory fitness and health care costs in diabetes : the veterans exercise testing study", Am J Med, 132(9), pp.1084~1090 (2019)
  23. 전미양, "건강율동체조가 여성 노인의 균형, 우울, 의료비용, 의료기관 이용 및 낙상에 미치는 효과", Journal of Korean Academy of Nursing, 35(8), pp.1268~1276 (2005), 한국간호과학회
  24. KW K, "Medical cost of physical inactivity", Official J Korean Acad Kinesiol, 8, pp.57~62 (2006)
  25. 차지은, "당뇨 환자의 운동실천에 따른 건강행태, 의료이용 및 의료비용 비교", 지역사회간호학회지, 26(1), pp.31~41 (2015), 한국지역사회간호학회[DOI]
  26. 곽광일, "한국 노인의 신체활동 정도와 의료이용과의 관련성", 한국산학기술학회논문지, 16(1), pp.617~626 (2015), 한국산학기술학회[DOI]
  27. 권욱동, "지역주민의 신체활동 수준에 따른 직접 의료비 지출의 차이", 한국산학기술학회논문지, 17(6), pp.106~112 (2016), 한국산학기술학회[DOI]
  28. 권만근, "비만 노인 여성의 신체활동에 따른 삶의 질과 주관적 건강상태 및 의료비의 차이", 한국체육교육학회지, 25(4), pp.309~323 (2021), 한국체육교육학회
  29. Williams PT, "Physical fitness and activity as separate heart disease risk factors : a meta-analysis", Med Sci Sports Exerc, 33(5), pp.754~ (2001)
  30. Developnent of criterion referenced health finess standards for Korean adults and older adults, "Park S", Korean Inst Sport Sci, ~ (2016)
  31. 박세정, "한국 성인의 질병예방을 위한 건강체력 기준개발: The Korea Institute of Sport Science Fitness Standards Study (KISS FitS)", 한국체육학회지, 57(6), pp.235~247 (2018), 한국체육학회
  32. 박세정, "성인여성의 심폐체력 수준과 우울증상(Depressive Symptom)과의 관련성", 운동과학, 24(4), pp.391~397 (2015), 한국운동생리학회[DOI]
  33. 박세정, "성인의 심폐체력 수준: 2014-2015 Korea Institute of Sports Science Fitness Standards (KISS FitS) Project 자료를 중심으로", 체육과학연구, 27(4), pp.714~725 (2016), 국민체육진흥공단 한국스포츠정책과학원
  34. 박세정, "한국 노인의 자립생활을 위한 기능체력 기준 개발", 한국체육학회지, 57(5), pp.385~396 (2018), 한국체육학회
  35. Park S, "Developnent of criterion referenced health finess standards for korean adolescents", Korean Inst Sport Sci (2018)
  36. 박세정, "Bruce Protocol을 이용한 최대산소섭취량 예측식의 타당도 검증", 한국체육측정평가학회지, 16(3), pp.41~50 (2014), 한국체육측정평가학회
  37. Welk GJ, "Development of youth aerobic-capacity standards using receiver operating characteristic curves", Am J Prev Med, 41(4), pp.S111~S116 (2011)
  38. Katzmarzyk P, "Adiposity, physical fitness and incident diabetes : the physical activity longitudinal study", Diabetologia, 50(3), pp.538~544 (2007)
  39. Kawakami R, "Reference values for cardiorespiratory fitness and incidence of type 2 diabetes", J Epidemiol, 24(1), pp.25~30 (2014)
  40. Blair SN, "Changes in coronary heart disease risk factors associated with increased treadmill time in 753 men", Am J Epidemiol, 118(3), pp.352~359 (1983)

관련 논문AI추천

Effect of participating in physical fitness assessment on healthcare costs in Korean adults박세정, 오인환, 이미현, 이승희, 이효진국민체육진흥공단 한국스포츠과학원 · IJASS(International Journal of Applied Sports Sciences)2021 · 제33권 제1호성인의 심폐체력 수준: 2014-2015 Korea Institute of Sports Science Fitness Standards (KISS FitS) Project 자료를 중심으로고병구, 박세정, 박수현, 송주호, 송홍선, 정진욱국민체육진흥공단 한국스포츠과학원 · 체육과학연구2016 · 제27권 제4호Comparison of Prevalence of Hypertension and Medical Expenses According to the Level of Physical Activity of Korean Adults이병근대한운동학회 · 아시아 운동학 학술지2018 · 제20권 제4호Comparison of Prevalence of Hyperlipidemia, Medical Expenses, Inpatient, Emergency and Outpatient According to the Level of Physical Activity of Korean Adults: A Cross-Sectional Study of 2018 Korea Medical Panel이병근대한운동학회 · 아시아 운동학 학술지2021 · 제23권 제1호Prevalence of Ischemia, Health-Related Quality of Life, Medical use and Expenses by Physical Activity and Ischemia Status in Korean Adults이병근한국운동생리학회 · 운동과학2021 · 제30권 제4호Low cardiorespiratory fitness is an independent predictor of elevated resting blood pressures in middle-aged Korean women강현식, 윤승호, 조진경한국운동생리학회 · 운동과학2009 · 제18권 제1호

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