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HOME > J Korean Acad Community Health Nurs > Volume 26(1); 2015 > Article
Original Article
The Comparison of Health Behaviors, Use of Health Services, and Health Expenditures among Diabetic Patients according to the Practice of Exercise
Ji Eun Cha, Soon Nyung Yun
Journal of Korean Academy of Community Health Nursing 2015;26(1):31-41.
DOI: https://doi.org/10.12799/jkachn.2015.26.1.31
Published online: March 31, 2015

College of Nursing, Seoul National University, Seoul, Korea.

• Received: January 8, 2015   • Revised: March 11, 2015   • Accepted: March 20, 2015

© 2015 Korean Academy of Community Health Nursing

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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  • Purpose
    The purpose of this study was to compare the use of health services and health expenditures between non-exercise and exercise groups of diabetic patients and among three groups divided according to exercise intensity.
  • Methods
    Data were obtained from the Korean Health Panel Survey of 2011. The participants of this study were 864 diabetic patients who did exercise (walk, moderate exercise, or vigorous exercise) or not. Data were subsequently analyzed using the SPSS 21 Program.
  • Results
    The exercise group showed higher percentages of medication compliance, non-smokers, and regular diet than the non-exercise group. The hospitalization percentage, the number of outpatient hospital visits, and health expenditures were higher in the non-exercise group than in the exercise group. There was no difference among the three groups divided according to exercise intensity in the use of health services and health expenditures.
  • Conclusion
    These results show that exercise is a way to reduce diabetic patients' use of health services and their health expenditures.
Table 1

General Characteristics of the Participants

Variables Categories Total (n=864) Exercise practice Exercise intensity
χ2 (p) Non-exercise (n=190) Exercise (n=674) Walka (n=365) Moderate exerciseb (n=145) Vigorous exercisec (n=164) χ2 or F (p)
n (%) or M±SD n (%) or M±SD n (%) or M±SD n (%) or M±SD n (%) or M±SD
Gender Male 423 (49.0) 0.68 (.409) 88 (46.3) 335 (49.7) 138 (37.8) 83 (57.2) 114 (69.5) 49.69 (<.001)
Female 441 (51.0) 102 (53.7) 339 (50.3) 227 (62.2) 62 (42.8) 50 (30.5)
Age (year) 20~39 15 (1.7) 20.84 (<.001) 1 (0.5) 14 (2.1) 7 (1.9) 1 (0.7) 6 (3.7) 31.56 (<.001)
40~59 242 (28.0) 37 (19.5) 205 (30.4) 85 (23.3) 47 (32.4) 73 (44.5)
60~79 569 (65.9) 135 (71.1) 434 (64.4) 258 (70.7) 92 (63.4) 84 (51.2)
≥80 38 (4.4) 17 (8.9) 21 (3.1) 15 (4.1) 5 (3.4) 1 (0.6)
Average 4.75 (<.001) 68.9±10.41 64.9±10.37 66.7±10.34 64.9±9.23 60.9±10.31 18.67 (<.001) a>b, c
Partner Yes 679 (78.6) 5.13 (.023) 138 (72.6) 541 (80.3) 271 (74.2) 123 (84.8) 147 (89.6) 19.34 (<.001)
No 185 (21.4) 52 (27.4) 133 (19.7) 94 (25.8) 22 (15.2) 17 (10.4)
Education Non 75 (8.7) 9.84 (.020) 25 (13.2) 50 (7.4) 34 (9.3) 7 (4.8) 9 (5.5) 30.15 (<.001)
High school 676 (78.2) 149 (78.4) 527 (78.2) 299 (81.9) 115 (79.3) 113 (68.9)
University 94 (10.9) 14 (7.4) 80 (11.9) 27 (7.4) 20 (13.8) 33 (20.1)
Postgraduate 19 (2.2) 2 (1.1) 17 (2.5) 5 (1.4) 3 (2.1) 9 (5.5)
Job Yes 409 (47.3) 3.24 (.072) 79 (41.6) 330 (49.0) 141 (38.6) 81 (55.9) 108 (65.9) 37.08 (<.001)
No 455 (52.7) 111 (58.4) 344 (51.0) 224 (61.4) 64 (44.1) 56 (34.1)
Total income (10,000 won) Average -2.50 (.013) 2,673.8±2,743.26 3,218.3±2,624.89 2,790.2±2,385.61 3,542.4±2,762.36 3,884.5±2,836.79 11.59 (<.001) a<b, c
Number of chronic disease 1.87 (.061) 5.0±2.55 4.6±2.61 5.0±2.77 4.4±2.44 3.8±2.16 12.24 (<.001) a>c

Scheffé test.

Table 2

Health Behaviors of the Participants

Variables Categories Total (n=864) Exercise practice Exercise intensity
χ2 or F (p) Non-exercise (n=190) Exercise (n=674) Walk (n=365) Moderate exercise (n=145) Vigorous exercise (n=164) χ2 or F (p)
n (%) or M±SD n (%) or M±SD n (%) or M±SD n (%) or M±SD n (%) or M±SD
Medication compliance Compliance 747 (86.5) 7.32 (.007) 153 (80.5) 594 (88.1) 324 (88.8) 129 (89.0) 141 (86.0) 0.99 (.617)
Noncompliance 117 (13.5) 37 (19.5) 80 (11.9) 41 (11.2) 16 (11.0) 23 (14.0)
Smoking Smoker 161 (18.6) 6.64 (.036) 47 (24.7) 114 (16.9) 50 (13.7) 29 (20.0) 35 (21.3) 25.07 (<.001)
Nonsmoker 222 (25.7) 41 (21.6) 181 (26.9) 81 (22.2) 39 (26.9) 61 (37.2)
Lifelong nonsmoker 481 (55.7) 102 (53.7) 379 (56.2) 234 (64.1) 77 (53.1) 68 (41.5)
Drinking Drinker 478 (55.3) 19.97 (<.001) 82 (43.2) 396 (58.8) 186 (51.0) 92 (63.4) 118 (72.0) 30.25 (<.001)
Nondrinker 109 (12.6) 39 (20.5) 70 (10.4) 35 (9.6) 17 (11.7) 18 (11.0)
Lifelong nonsmoker 277 (32.1) 69 (36.3) 208 (30.9) 144 (39.5) 36 (24.8) 28 (17.1)
Diet Regular 763 (88.3) 6.26 (.012) 158 (83.2) 605 (89.8) 331 (90.7) 132 (91.0) 142 (86.6) 2.39 (.302)
Irregular 101 (11.7) 32 (16.8) 69 (10.2) 34 (9.3) 13 (9.0) 22 (13.4)
BMI Underweight 17 (2.0) 7.87 (.096) 4 (2.2) 13 (2.0) 10 (2.8) 1 (0.7) 2 (1.3) 10.70 (.219)
Normal 274 (32.7) 70 (37.8) 204 (31.2) 123 (34.8) 34 (23.9) 47 (29.6)
Overweight 258 (30.8) 42 (22.7) 216 (33.0) 106 (30.0) 55 (38.7) 55 (34.6)
Obesity 258 (30.8) 60 (32.4) 198 (30.3) 104 (29.5) 46 (32.4) 48 (30.2)
Extremely-obese 32 (3.8) 9 (4.9) 23 (3.5) 10 (2.8) 6 (4.2) 7 (4.4)
Average -0.85 (.391) 23.9±3.20 24.1±2.98 23.9±2.94 24.4±3.09 24.3±2.95 1.67 (.188)
Table 3

Utilization of Health Services

Variables Categories Total (n=864) Exercise practice Exercise intensity
χ2 (p) Non-exercise (n=190) Exercise (n=674) Walk (n=365) Moderate exercise (n=145) Vigorous exercise (n=164) χ2 (p)
n (%) n (%) n (%) n (%) n (%)
ER Yes 105 (12.2) 0.96 (.326) 27 (14.2) 78 (11.6) 50 (13.7) 16 (11.0) 12 (7.3) 4.55 (.103)
No 759 (87.8) 173 (85.8) 596 (88.4) 315 (86.3) 129 (89.0) 152 (92.7)
In-patient Yes 175 (20.3) 12.74 (<.001) 58 (30.5) 125 (18.5) 77 (21.0) 23 (15.9) 25 (15.2) 4.65 (.325)
No 681 (78.8) 132 (69.5) 549 (81.5) 288 (78.9) 122 (84.1) 139 (84.8)
Table 4

The Number of Days of Health Services

Between non-exer group and exer group
Variables t-test ANCOVA
Non-exercise (n=190) Exercise (n=674) t p Non-exercise (n=190) Exercise (n=674) F p
M±SD M±SD M±SD M±SD
ER (n=19, 57) 1.0±0.17 1.0±0.23 -0.23 .817 1.0±0.05 1.0±0.03 0.11 .739
Inpatient (n=41, 96) 15.5±13.18 10.9±18.72 1.42 .157 15.9±2.80 10.7±1.80 2.31 .130
Outpatient (n=190, 674) 29.3±29.88 22.4±21.67 3.01 .003 27.3±1.61 22.9±0.85 5.74 .017
3 groups by exercise intensity
Variables ANOVA ANCOVA
Walk (n=365) Moderate exercise (n=145) Vigorous exercise (n=164) F p Walk (n=365) Moderate exercise (n=145) Vigorous exercise (n=164) F p
M±SD M±SD M±SD M±SD M±SD M±SD
ER (n=39, 10, 8) 1.0±0.27 1.0±0.00 1.0±0.00 0.71 .496 1.0±0.04 1.0±0.08 0.9±0.08 0.83 .440
Inpatient (n=59, 16, 21) 10.7±14.99 7.6±9.50 13.9±30.45 0.50 .604 10.7±2.53 7.8±4.77 13.8±4.45 0.42 .657
Outpatient (n=365, 145, 164) 23.1±21.95 24.4±23.08 18.9±19.37 2.97 .052 21.4±1.07 25.0±1.68 22.1±1.61 1.61 .200

Age, the number of chronic disease and total income-adjusted means±standard error.

Table 5

Health Expenditures

Between non-exer group and exer group
Variables Categories t-test ANCOVA
Non-exercise (n=190) Exercise (n=674) t p Non-exercise (n=190) Exercise (n=674) F p
M±SD M±SD M±SD M±SD
Medication (monthly) 31,234.7±24,174.73 28,730.7±31,510.78 0.88 .378 29,708.5±2,364.65 29,162.5±1,245.91 0.88 .839
ER Personnel expenses 73,091.9±95,705.60 49,934.1±6,5091.57 0.98 .336 72,857.8±17,542.71 50,012.2±9,992.36 1.25 .266
Total (personnel+insurers) expenses 284,182.4±326,872.18 148,774.0±101,452.52 1.15 .284 298,588.9±65,273.90 144,341.2±35,727.99 4.22 .049
Inpatient Personnel expenses 917,964.6±900,511.30 878,255.4±1,279,444.42 0.18 .857 927,343.7±191,242.22 874,249.8±122,897.76 0.05 .819
Total (personnel+insurers) expenses 2,609,640.2±2,185,425.87 2,510,475.7±2,862,952.12 0.17 .862 2,633,079.0±487,960.23 2,500,058.4±320,508.44 0.05 .823
Outpatient Personnel expenses 11,895.9±17,649.35 16,421.6±26,860.69 -2.74 .006 12,795.6±1,828.37 16,166.8±965.90 2.63 .105
Total (personnel+insurers) expenses 24,403.3±31,829.01 25,483.4±30,233.42 -0.41 .680 25,116.6±2,319.27 25,273.0±1,250.90 0.00 .953
Individual total expenses1 1,393,766.7±1,757,129.41 1,073,657.3±1,311,799.94 2.33 .020 1,354,487.5±102,356.62 1,084,730.1±53,941.43 5.38 .021
Individual total expenses2 1,503,210.2±,1924,504.47 1,096,801.4±1,324,625.10 2.73 .007 1,456,657.0±106,251.84 1,109,924.7±55,994.19 8.25 .004
3 groups by exercise intensity
Variables ANOVA ANCOVA
Walk (n=365) Moderate exercise (n=145) Vigorous exercise (n=164) F p Walk (n=365) Moderate exercise (n=145) Vigorous exercise (n=164) F p
M±SD M±SD M±SD M±SD M±SD M±SD
Individual total expenses1 1,093,994.6±1,255,401.97 1,090,986.2±1,531,817.26 1,013,073.2±1,227,865.47 0.23 .794 1,057,798.6±68,489.08 1,104,338.8±107,395.80 1,081,825.6±103,161.57 0.07 .933
Individual total expenses2 1,123,689.7±1,274,848.70 1,113,413.8±1,537,682.34 1,022,270.5±1,232,439.57 0.34 .709 1,085,623.4±69,127.65 1,128,073.5±108,397.13 1,094,030.1±104,123.43 0.05 .947

Age, The number of Chronic disease and Total income-adjusted means±standard error.

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References

    Citations

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