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首页> 外文期刊>Preventive Medicine: An International Journal Devoted to Practice and Theory >Neighborhood walkability and hospital treatment costs: A first assessment
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Neighborhood walkability and hospital treatment costs: A first assessment

机译：邻里步行和医院治疗费用：第一次评估

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Health system expenditure is a global concern, with hospital cost a major component. Built environment has been found to affect physical activity and health outcomes. The purpose of the study was a first assessment of the relationship between neighborhood walkability and hospital treatment costs. For 88 neighborhoods in the Australian Capital Territory (ACT), 2011-2013, a total of 30,690 public hospital admissions for the treatment of four diagnostic groups (cancers, endocrine, nutritional and metabolic diseases, circulatory diseases and respiratory diseases) were extracted from the ACT admitted patient care database and analyzed in relation to the Walk Score (R) index as a measure of walkability. Hospital cost was calculated according to the cost weight of the diagnosis related group assigned to each admission. Linear regressions were used to analyze the associations of walkability with hospital cost per person, admissions per person and cost per admission at the neighborhood level. An inverse association with neighborhood walkability was found for cost per person and admissions per person, but not cost per admission. After adjusting for age, sex and socioeconomic status, a 20-unit increase in walkability was associated with 12.1% (95% CI: 7.1-17.0%) lower cost and 12.5% (8.1-17.0%) fewer admissions. These associations did not vary by neighborhood socioeconomic status. This exploratory analysis suggests the potential for improved population health and reduced hospital cost with greater neighborhood walkability. Further research should replicate the analysis with data from other urban settings, and focus on the behavioral mechanisms underlying the inverse walkability-hospital cost association. (C) 2017 Elsevier Inc. All rights reserved.
机译：卫生系统支出是一个全球关注的问题，医院成本为一个主要的组成部分。已发现建筑环境影响身体活动和健康结果。该研究的目的是对邻里可行性和医院治疗成本之间关系的第一次评估。澳大利亚资本领土的88个社区（法案），共有30,690名公立医院入学，治疗四种诊断群（癌症，内分泌，营养和代谢疾病，循环疾病和呼吸系统疾病）是从中提取的ACT承认患者护理数据库，并与步行得分（R）指数有关作为一种可行性的衡量标准。根据分配给每次入学的诊断相关组的成本重量计算医院费用。线性回归用于分析每人医院费用的行动关系，每人入学和邻里级别的每笔费用。每个人的成本和每人入学都有与邻居步行的反向关联，但每人的入学费用也是如此。调整年龄，性别和社会经济地位后，可行性的20单位增加与12.1％（95％CI：7.1-17.0％）降低成本，12.5％（8.1-17.0％）录取较少。这些协会没有因邻域社会经济地位而变化。该探索性分析表明，较大的人口健康和降低医院成本的潜力，并具有更大的邻域行动。进一步的研究应通过来自其他城市环境的数据进行复制分析，并专注于逆行力 - 医院成本协会的行为机制。 （c）2017年Elsevier Inc.保留所有权利。

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