Health-related behaviours in adults with diabetes: associations with health care utilization and costs.
OBJECTIVE
The primary objective of this study was to examine whether physical activity, diet, and smoking behaviours are associated with health resource utilization and costs in the Canadian context. A secondary objective was to evaluate demographic and health behavioural characteristics of the participants of the study to assess the degree of respondent bias.


METHODS
Self-reported physical activity, diet and smoking status were obtained from a large population-based sample of adults with diabetes (N = 2311). Resource utilization and cost information was obtained by linking these data to the provincial government's administrative database. Multiple regression models examined predictors of resource utilization and costs for individuals with type 1 (T1D) and type 2 (T2D) diabetes separately. To assess the degree of responder bias, characteristics of individuals who consented to link data were compared with those who did not consent.


RESULTS
Various measures of health care utilization and costs were negatively associated with physical activity behaviour in both T1D and T2D groups. Ever having smoked cigarettes was associated with higher resource utilization in individuals with T2D when controlling for demographic and health variables. Significant differences in demographic and health behavioural characteristics of the participants who provided consent for data linkage and those who did not were also found.


CONCLUSIONS
These findings are of interest considering that PA is a critical but understudied component of individuals with diabetes, and this appears to be one of the first studies to directly examine the relationship between health-related behaviours and health care utilization and costs. The findings may be useful in guiding targeted health promotion programs for individuals with diabetes. The results also indicate that studies involving linkage of administrative and survey data could be over-represented by healthy individuals.
Plotnikoff
Ronald C
RC
Centre for Health Promotion Studies, School of Public Health, University of Alberta, Edmonton, AB. ron.plotnikoff@ualberta.ca
Karunamuni
Nandini D
ND
Johnson
Jeffrey A
JA
Kotovych
Maria
M
Svenson
Lawrence W
LW
D000328:Adult; D000368:Aged; D000416:Alberta; D003922:Diabetes Mellitus, Type 1; D003924:Diabetes Mellitus, Type 2; D005260:Female; D015438:Health Behavior; D006296:Health Services / Q000191:economics* / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012309:Risk-Taking; D011795:Surveys and Questionnaires