|Rejeski, W. Jack|
Submitted to: Journal of Physical Activity and Health
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 12/4/2008
Publication Date: 11/6/2009
Citation: Groessl, E.J., Kaplan, R.M., Blair, S.N., Rejeski, W., Katula, J.A., King, A.C., Fielding, R., Glynn, N.W., Pahor, M. 2009. A Cost Analysis of a Physical Activity Intervention for Older Adults. Journal of Physical Activity and Health. 6:767-774. Interpretive Summary: As the life expectancy in the United States has continued to rise, the maintenance of physical and cognitive independence of older Americans has emerged as a major clinical and public health priority. A critical factor in an older person’s ability to function independently is mobility, or the ability to move without assistance. Several studies suggest that regular physical activity may improve physical performance, but definitive evidence showing that mobility disability can be prevented is lacking. We conducted "Lifestyle Interventions and Independence For Elders-LIFE" pilot study. In this paper, we examined the cost-effectiveness of the physical activity intervention and the healthy aging control intervention. A total of 424 sedentary persons at risk of disability and in the age range of 70-89 years were followed for an average of 1.2 years. Participants were assigned to a Moderate intensity PA intervention compared to a successful aging (SA) health education intervention. The Short Physical Performance Battery score in the PA group was reduced and remained unchanged in the SA group. The average cost per participant was $1033 and $273 for the PA and SA respectively. Preliminary cost/effectiveness analysis estimated that $22,382 per participant in the PA group could be avoided. There was no difference between groups in self-reported health care utilization. This was a pilot study and a larger and longer follow up is need to determine if participation in a regular physical activity program can reduce health care utilization and costs in older adults.
Technical Abstract: We examined the costs of a physical activity (PA) and an educational comparison intervention. 424 older adults at risk for mobility disability were randomly assigned to either condition. The PA program consisted of center-based exercise sessions 3x weekly for 8 weeks, 2x weekly for weeks 9-24 and weekly behavioral counseling for 10 weeks. Optional sessions were offered during maintenance weeks (25-52). The comparison intervention consisted of weekly education meetings for 24 weeks, and then monthly for 6 months. Cost analyses were conducted from an organizational perspective, with a 1-year time horizon. Intervention costs were estimated by tracking personnel activities and materials used for each intervention and multiplying by national unit cost averages. Self-reported healthcare utilization and adverse events were briefly examined. The average cost/participant was $1033 and $272 for the PA and the comparison interventions, respectively. A preliminary cost/effectiveness analysis gauged the cost/disability avoided to be $22,382. The interventions groups barely differed on self-reported healthcare utilization and adverse events. Costs for this PA program for older adults are comparable to those of other PA interventions. The results are preliminary and a longer study is required to fully assess the costs and health benefits of these interventions.