The economic implications of self-care: the effect of lifestyle, functional adaptations, and medical self-care among a national sample of Medicare beneficiaries.
OBJECTIVE
Self-care includes actions taken by individuals to promote or ensure their health, to recover from diseases or injuries, or to manage their effects. This study measured associations between self-care practices (lifestyle practices, adaptations to functional limitations, and medical self-care) and Medicare expenditures among a national sample of adults 65 years and older.


METHODS
Regression models of Medicare use and expenditures were estimated by using the National Survey of Self-Care and Aging and Medicare claims for 4 years following a baseline interview.


RESULTS
Lifestyle factors (swimming and walking) and functional adaptations (general home modifications) were associated with reductions in monthly Medicare expenditures over a 12-month follow-up period. Expenditure reductions were found over the 48-month follow-up period for participation in active sports, gardening, and medical self-care. Practices associated with increases in expenditures included smoking, physical exercise (possibly of a more strenuous nature), and specific home modifications.


CONCLUSIONS
Certain self-care practices appear to have significant implications for Medicare expenditures and presumptively for the health status of older adults. Such practices should be encouraged among older adults as a matter of national health policy.
Stearns
S C
SC
Department of Health Policy and Administration, University of North Carolina at Chapel Hill, 27599-7400, USA. sally_stearns@unc.edu
Bernard
S L
SL
Fasick
S B
SB
Schwartz
R
R
Konrad
T R
TR
Ory
M G
MG
DeFriese
G H
GH
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D004779:Environment Design; D005260:Female; D005102:Health Expenditures; D006304:Health Status; D006801:Humans; D008019:Life Style; D008297:Male; D006278:Medicare / Q000191:economics*; D018803:Models, Economic; D012044:Regression Analysis; D012648:Self Care / Q000191:economics*; D014481:United States