Chest ACCP Member Benefits
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

Guest Access | Sign In via User Name/Password
This Article
Right arrow Full Text Free
Right arrow Full Text (PDF) Free
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Article Archive
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via ISI Web of Science (3)
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Weiss, J. P.
Right arrow Articles by Heidenreich, P. A.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Weiss, J. P.
Right arrow Articles by Heidenreich, P. A.
(Chest. 2004;126:608-613.)
© 2004 American College of Chest Physicians

Health-Care Costs and Exercise Capacity*

J. Peter Weiss, MD, MSc; Victor F. Froelicher, MD; Jonathan N. Myers, PhD and Paul A. Heidenreich, MD

* From the Division of Cardiovascular Medicine, Stanford University Medical Center and Veterans Affairs Health Care System, Palo Alto, CA.

Correspondence to: Victor Froelicher, MD, Cardiology Division (111C), VA Palo Alto Health Care System, 3801 Miranda Ave, Palo Alto, CA 94304; e-mail: vicmd{at}aol.com

Background: While the beneficial effect of exercise capacity on mortality is well-accepted, its effect on health-care costs remains uncertain. This study investigates the relationship between exercise capacity and health-care costs.

Methods: The Veterans Affairs Health Care System recently implemented a Decision Support System that provides data on patterns of care, patient outcomes, workload, and costs. Total inpatient and outpatient costs were derived from existing administrative and clinical data systems, were adjusted for relative value units, and were expressed in relative cost units. We used univariable and multivariable analyses to evaluate the 1-year total costs in the year following a standard exercise test. Costs were compared with exercise capacity estimated in metabolic equivalents (METs), other test results, and clinical variables for 881 consecutive patients who were referred for clinical reasons for treadmill testing at the Palo Alto Veterans Affairs Health Care System facility between October 1, 1998, and September 30, 2000.

Results: The patients had a mean age of 59 years, 95% were men, and 74% were white. Eight patients (< 1%) died during the year of follow-up. Exercise testing showed an average maximum heart rate of 138 beats/min, 8.2 METs, and a peak Borg scale of 17. In unadjusted analysis, costs were incrementally lower by an average of 5.4% per MET increase (p < 0.001). In a multivariable analysis adjusting for demographic variables, treadmill test performance and results, and clinical history, METs were found to be the most significant predictor of cost (F-statistic, 21.8; p < 0.001).

Conclusion: These findings are consistent with the hypothesis that exercise capacity is inversely associated with health-care costs.

Key Words: exercise capacity • exercise testing • health-care costs




This article has been cited by other articles:


Home page
 Eur Heart JHome page
V. F. Froelicher
Screening with the exercise test: time for a guideline change?
Eur. Heart J., July 2, 2005; 26(14): 1353 - 1354.
[Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 2004 by the American College of Chest Physicians.