Participation in Fitness-Related Activities of an Incentive-Based Health Promotion Program and Hospital Costs: A Retrospective Longitudinal Study

Patel, Deepak; Lambert, Estelle V.; Silva, Roseanne da; Greyling, Mike; Kolbe-Alexander, Tracy; Noach, Adam; Conradie, Jaco; Nossel, Craig; Borresen, Jill; Gaziano, Thomas A.

doi:10.4278/ajhp.100603-quan-172

Cited by 31 publications

(37 citation statements)

References 46 publications

(41 reference statements)

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“…The studies were undertaken across a number of health insurance settings including private health insurance (19,(28)(29)(30)(31), employer-sponsored health plans (9,32-40), veteran's affairs (21,27,41) and public health insurance (20,22). The majority of the studies (14) were conducted in the USA (9,21,27,28,(32)(33)(34)(35)(36)(37)(38)(39)(40)(41), and the remainder were from South Africa (four) (19,(29)(30)(31), UK (one) (22) and Germany (one) (20). Studies incentivizing weight loss, increased physical activity and improved diets are discussed subsequently.…”

Section: Results Of Search Strategymentioning

confidence: 99%

Paying people to lose weight: the effectiveness of financial incentives provided by health insurers for the prevention and management of overweight and obesity – a systematic review

2017

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Curbing the obesity epidemic is likely to require a suite of interventions targeting the obesogenic environment as well as individual behaviour. Evidence suggests that the effectiveness of behaviour modification programmes can be enhanced by financial incentives that immediately reward weight loss behaviour. This systematic review investigated the effectiveness of incentives with a focus on assessing the relative effectiveness of incentives that target different behaviours as well as factors of importance when implementing these programmes in real-world settings (health insurer settings). A narrative review of the academic and grey literature including a variety of study designs was undertaken. Twenty studies met inclusion criteria and were assessed using the Effective Public Health Practice Project Quality Assessment Tool for Quantitative Studies. Results suggest that incentivizing weight loss is effective in the short term while the incentives are in place. There are various incentive designs, and although the relative effectiveness of each of these on weight loss is not clear, it appears that positive incentives increase the uptake into programmes and may reduce dropouts. As with other weight loss initiatives, there is a need to explore ways to maintain weight loss in the longer term - incentives for weight maintenance could play a role.

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Section: Results Of Search Strategymentioning

confidence: 99%

Paying people to lose weight: the effectiveness of financial incentives provided by health insurers for the prevention and management of overweight and obesity – a systematic review

2017

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“…If the “diabesity” epidemic is to be contained, it may be desirable to expand the coverage to other weight-loss interventions, such as partially reimbursing for gym membership or other fitness-related activities. Such strategies might prove to be a cost-effective in the long – run for managing diabetes mellitus and its complications in elderly individuals (36; 37). …”

Section: Discussionmentioning

confidence: 99%

Relation between BMI and Diabetes Mellitus and Its Complications among US Older Adults

Gray

Picone

Sloan

et al. 2015

Southern Medical Journal

215

126

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Objective This study determines effects of elevated body mass index (BMI) on type 2 diabetes mellitus (DM) onset and its complications among U.S. elderly. Design and Methods Data came from the Medicare Current Beneficiary Survey (MCBS), 1991-2010. A Cox proportional hazard model was used to assess effects of elevated BMI at the first MCBS interview on DM diagnosis, complications, and insulin dependence onset among Medicare beneficiaries with no prior DM diagnosis and not enrolled in Medicare Advantage (N=14,657). Results Among DM-diagnosed individuals, elevated BMIs were associated with progressively higher risk of adverse outcomes. For women, hazard ratio (HR) of insulin dependence ranged from a 1.77 at 25 ≤ BMI ≤ 27.49 to 3.57 at BMI ≥ 40. A similar pattern was observed in risk for cardiovascular (HR=1.34 to HR=2.45), cerebrovascular (HR=1.30 to HR=2.00), renal (HR=1.31 to HR=2.23), and lower extremity complications (HR=1.41 to HR=2.95). In men, increased risks for DM complications occurred at higher BMI (27.5 ≤ BMI ≤ 29.99) levels than in women. Ocular complications occurred at higher BMI levels than other complication types in both genders. Conclusions Having even moderately elevated BMI is associated with increased risk of developing DM complications.

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“…Devices can also use “hooks” and “nudges” to emphasize immediate and future benefits, such as through goal formation or gamification of health activities. For example, financial incentives for participation in a health promotion program have been shown to result in an increase in fitness activity and decrease in hospital admissions (43). …”

Section: Maintaining Precision Healthmentioning

confidence: 99%

Toward achieving precision health

et al. 2018

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Health care systems primarily focus on patients after they present with disease, not before. The emerging field of precision health encourages disease prevention and earlier detection by monitoring health and disease based on an individual’s risk. Active participation in health care can be encouraged with continuous health-monitoring devices, providing a higher-resolution picture of human health and disease. However, the development of monitoring technologies must prioritize the collection of actionable data and long-term user engagement.

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Participation in Fitness-Related Activities of an Incentive-Based Health Promotion Program and Hospital Costs: A Retrospective Longitudinal Study

Abstract: We observed an increase in fitness-related activities over time amongst members of this incentive-based health promotion program, which was associated with a lower probability of hospital admission and lower hospital costs in the subsequent 2 years.

Cited by 31 publications

References 46 publications

Paying people to lose weight: the effectiveness of financial incentives provided by health insurers for the prevention and management of overweight and obesity – a systematic review

Paying people to lose weight: the effectiveness of financial incentives provided by health insurers for the prevention and management of overweight and obesity – a systematic review

Relation between BMI and Diabetes Mellitus and Its Complications among US Older Adults

Toward achieving precision health

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