Improving walking speed reduces hospitalization costs in outpatients with cardiovascular disease. An analysis based on a
- PDF / 773,244 Bytes
- 11 Pages / 595.276 x 790.866 pts Page_size
- 73 Downloads / 209 Views
(2020) 20:1048
RESEARCH ARTICLE
Open Access
Improving walking speed reduces hospitalization costs in outpatients with cardiovascular disease. An analysis based on a multistrata non-parametric test Stefano Bonnini1†, Gianni Mazzoni2,3†, Michela Borghesi4, Giorgio Chiaranda5,6, Jonathan Myers7,8, Simona Mandini2* , Andrea Raisi2, Sabrina Masotti2 and Giovanni Grazzi2,3
Abstract Background: To assess the association between walking speed (WS) and its improvement on hospitalization rates and costs in outpatients with cardiovascular disease. Methods: Six hundred forty-nine patients participating in an exercise-based secondary prevention program were studied. Patients were divided at baseline into two groups characterized by low and high WS based on the average WS maintained during a moderate 1-km treadmill-walking test. WS and other covariates were grouped into three domains (demographic factors, medical history and risk factors), and used to estimate a propensity score, in order to create homogeneous groups of patients. All-cause hospitalization was assessed 3 years after baseline as a function of WS. Hospitalization and related costs were also assessed during the fourth-to-sixth years after enrollment. To test whether the hospitalization costs were related to changes in WS after 36 months, a multistrata permutation test was performed by combining within strata partial tests. Results: The results support the hypothesis that hospitalization costs are significantly reduced in accordance with an improvement in WS. This effect is most evident among older patients, overweight or obese, smokers, and those without a history of coronary artery bypass surgery. Conclusions: The present study supports growing evidence of an inverse association between WS, risk of hospitalization and consequent health-care costs. The joint use of propensity score and multistrata permutation approaches represent a flexible and robust testing method which avoids the possible effects of several confounding factors typical of these studies. Keywords: Cardiovascular disease, Secondary prevention, Physical activity, Hospitalization costs, Permutation test
* Correspondence: [email protected] † Stefano Bonnini and Gianni Mazzoni contributed equally to this work. 2 Center for Exercise Science and Sport, University of Ferrara, Via Gramicia , 35, 44121 Ferrara, Italy Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons lice
Data Loading...
