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

Sapna Kaul, Jaqueline C. Avila, Daniel Jupiter, Ana Rodriguez, Anne C. Kirchhoff, Yong Fang Kuo

Research output: Contribution to journalArticle

3 Citations (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)1-12
Number of pages12
JournalJournal of Cancer Research and Clinical Oncology
DOIs
StateAccepted/In press - Aug 22 2017

Fingerprint

Health Care Costs
Survivors
Body Mass Index
Smoking
Exercise
Health Expenditures
Health
Hospital Emergency Service
Neoplasms
Delivery of Health Care
Comorbidity
Outpatients
Confidence Intervals
Insurance Coverage
Hospital Departments
Health Status
Research Design
Survival Rate
Demography

Keywords

  • Adult cancer survivors
  • Body mass index
  • Health care burden
  • Physical activity
  • Smoking

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

@article{aaba9982aa4b400690f217fd593b2f8c,
title = "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.",
keywords = "Adult cancer survivors, Body mass index, Health care burden, Physical activity, Smoking",
author = "Sapna Kaul and Avila, {Jaqueline C.} and Daniel Jupiter and Ana Rodriguez and Kirchhoff, {Anne C.} and Kuo, {Yong Fang}",
year = "2017",
month = "8",
day = "22",
doi = "10.1007/s00432-017-2494-3",
language = "English (US)",
pages = "1--12",
journal = "Journal of Cancer Research and Clinical Oncology",
issn = "0171-5216",
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TY - JOUR

T1 - Modifiable health-related factors (smoking, physical activity and body mass index) and health care use and costs among adult cancer survivors

AU - Kaul, Sapna

AU - Avila, Jaqueline C.

AU - Jupiter, Daniel

AU - Rodriguez, Ana

AU - Kirchhoff, Anne C.

AU - Kuo, Yong Fang

PY - 2017/8/22

Y1 - 2017/8/22

N2 - 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.

AB - 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.

KW - Adult cancer survivors

KW - Body mass index

KW - Health care burden

KW - Physical activity

KW - Smoking

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U2 - 10.1007/s00432-017-2494-3

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