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

Patel, Deepak and Lambert, Estelle V. and da Silva, Roseanne and Greyling, Mike and Kolbe-Alexander, Tracy and Noach, Adam and Conradie, Jaco and Nossel, Craig and Borrenson, 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). pp. 341-348. ISSN 0890-1171


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. (Am J Health Promot 2011;25[5]:341–348.)

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Item Type: Article (Commonwealth Reporting Category C)
Refereed: Yes
Item Status: Live Archive
Additional Information: Permanent restricted access to Published version, in accordance with the copyright policy of the publisher.
Faculty / Department / School: Historic - Faculty of Sciences - Department of Nursing
Date Deposited: 28 Mar 2017 04:38
Last Modified: 28 Mar 2017 04:38
Uncontrolled Keywords: health insurance, wellness program, chronic disease, prevention research
Fields of Research : 11 Medical and Health Sciences > 1106 Human Movement and Sports Science > 110699 Human Movement and Sports Science not elsewhere classified
Socio-Economic Objective: C Society > 92 Health > 9204 Public Health (excl. Specific Population Health) > 920401 Behaviour and Health
C Society > 92 Health > 9202 Health and Support Services > 920205 Health Education and Promotion
Identification Number or DOI: 10.4278/ajhp.100603-QUAN-172

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