title: The economic implications of self-care: the effect of lifestyle, functional adaptations, and medical self-care among a national sample of Medicare beneficiaries.
abstract: 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.
authors.affiliation: Department of Health Policy and Administration, University of North Carolina at Chapel Hill, 27599-7400, USA. sally_stearns@unc.edu
authors.forename: S C
authors.initials: SC
authors.lastname: Stearns
authors.forename: S L
authors.initials: SL
authors.lastname: Bernard
authors.forename: S B
authors.initials: SB
authors.lastname: Fasick
authors.forename: R
authors.initials: R
authors.lastname: Schwartz
authors.forename: T R
authors.initials: TR
authors.lastname: Konrad
authors.forename: M G
authors.initials: MG
authors.lastname: Ory
authors.forename: G H
authors.initials: GH
authors.lastname: DeFriese
mesh_terms: 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