/ 23 September 2008

Link between fitness and wellness

The link between exercise and better health has been confirmed by three reports commissioned by Vitality, Discovery Health’s wellness incentive programme.

The Vitality Insured Persons (VIP) studies were performed by a group of researchers from the University of Cape Town, Discovery Health, the University of the Witwatersrand and Harvard Medical School.

The first study analysed data from almost one million members of the Discovery Health Medical Scheme, subdividing them into those who were registered with Vitality and those who were not.

Members registered with the wellness scheme were further sub­divided into three groups based on the points earned for various preventative and health-promoting activities. The groups were classified as highly engaged (15%), not engaged 35% and low engaged (49,6%).

The researchers looked at data on hospital costs for members who had been admitted at least once. The study, which was adjusted for age, gender, chronic status and plan type, found that hospital costs, days admitted per patient, admissions per patient and length of stay were all lower among highly engaged Vitality members.

Hospital admissions cost an average of R30 420 per patient for medical scheme members not registered with Vitality, compared with R27 538 for highly engaged members.

The study also looked at high-cost disease groups that may be affected by behaviour and found that costs among Vitality members were 7,2% lower for cardiovascular disease and 17,4% lower for musculoskeletal conditions.

The second VIP study, which covered 156 000 principal medical scheme members or their spouses who had been registered on chronic medication for at least a year, looked at the link between engagement in the wellness programme and medical expenses for lifestyle-related chronic diseases such as diabetes, hypertension, cardiac failure and chronic lung disease.

Of these members, 58% were not registered on Vitality, 67% were low engaged, 19% were not engaged and 14% were highly engaged members of the wellness scheme.

Costs per hospital admission for these chronic disease were lower for highly engaged members, although in some categories the result was not statistically significant.

The average chronic medication costs of highly engaged members were sometimes higher than those for non-registered members, for example, in hyper­tension and in both type 1 and type 2 diabetes.

The third Vitality study, which looked at about 950 000 Discovery Health Medical Scheme beneficiaries grouped both by their levels of “engagement” with the scheme and by fitness status, investigated whether fitness-related activities by members affected their healthcare costs. The report said that in Canada it has been estimated that more than two-thirds of the population do not exercise sufficiently and that inactivity is responsible for 2,5% of total direct healthcare costs.

Members considered to be highly engaged in fitness activities attended a gym at least 48 times a year, mediumly active members visited a gym between 24 and 48 times a year. Low-active members managed only four to 24 visits annually, while inactive members visited a gym less than four times a year. Of the members registered for Vitality 71% were considered inactive and just 12% highly active.

The Vitality study found that the number of hospital admissions and the length of stay, as well as the costs, were all significantly lower among the gym bunnies compared with all other beneficiaries, including those not registered with the wellness scheme. Admission rates for cancer and mental illness were 30% lower.