title: Health care use and costs associated with use of a health club membership benefit in older adults with diabetes.
abstract: OBJECTIVE
  The purpose of this study was to determine whether elective use of a health plan-sponsored health club membership had an impact on health care use and costs among older adults with diabetes.
  
  
  METHODS
  Administrative claims for 2,031 older adults with diabetes enrolled in a Medicare Advantage plan were obtained for this retrospective cohort study. Participants (n = 618) in the plan-sponsored health club benefit (Silver Sneakers [SS]) and control subjects (n = 1,413) matched on SS enrollment index date were enrolled in the plan for at least 1 year before the index date. Two-year health care use and costs of SS participants and control subjects were estimated in regressions adjusting for baseline differences.
  
  
  RESULTS
  SS participants were more likely to be male, had a lower chronic disease burden, used more preventive services, and had a lower prevalence of arthritis (P <or= 05). SS participants had lower adjusted total health care costs than control subjects in the first year after enrollment (-$1,633 [95% CI -$2,620 to -$646], P = 0.001), and adjusted total costs in year 2 trended lower (-$1,230 [-$2,494 to $33], P = 0.06). Participants who made on average >or=2 SS visits/week in year 1 had lower total costs in year 2 ($2,141 [-$3,877 to -$405], P = 0.02) than participants who made <2 visits/week.
  
  
  CONCLUSIONS
  Use of a health club benefit by older adults with diabetes was associated with slower growth in total health care costs over 2 years; greater use of the benefit was actually associated with declines in total costs.
authors.affiliation: Department of Biobehavioral Nursing and Health Systems, University of Washington, Seattle, Washington, USA. hqn@u.washington.edu
authors.forename: Huong Q
authors.initials: HQ
authors.lastname: Nguyen
authors.forename: Matthew L
authors.initials: ML
authors.lastname: Maciejewski
authors.forename: Sue
authors.initials: S
authors.lastname: Gao
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Lin
authors.forename: Barbara
authors.initials: B
authors.lastname: Williams
authors.forename: James P
authors.initials: JP
authors.lastname: Logerfo
mesh_terms: D000368:Aged; D003920:Diabetes Mellitus / Q000191:economics* / Q000534:rehabilitation*; D005260:Female; D020446:Fitness Centers / Q000191:economics*; D006760:Hospitalization / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D006278:Medicare; D014481:United States