Cardiovascular health and healthcare utilization and expenditures among medicare beneficiaries: the reasons for geographic and racial differences in stroke (REGARDS) study

Background-better cardiovascular health is associated with lower cardiovascular disease risk. methods and results-we determined the association between cardiovascular health and healthcare utilization and expenditures in the reasons for geographic and racial differences in stroke (regards) study. we included 6262 participants =65 years with medicare fee-for-service coverage for the year after their baseline study visit in 2003-2007. cardiovascular health at baseline was assessed using the american heart association's life's simple 7 (ls7) metric,which includes 7 factors: cigarette smoking,physical activity,diet,body mass index,blood pressure,cholesterol,and glucose. healthcare utilization and expenditures were ascertained using medicare claims in the year following baseline. overall,17.2%,31.1%,29.0%,16.4% and 6.4% of participants had 0 to 1,2,3,4,and 5 to 7 ideal ls7 factors,respectively. the multivariable-adjusted relative risk (95% confidence interval [ci]) for having any inpatient and outpatient encounters comparing participants with 5 to 7 versus 0 to 1 ideal ls7 factors were 0.55 (0.39,0.76) and 1.00 (0.98,1.02),respectively. among participants with 0 to 1 and 5 to 7 ideal ls7 factors,mean inpatient expenditures were $3995 and $1250,respectively,mean outpatient expenditures were $5166 and $2853,respectively,and mean total expenditures were $9147 and $4111,respectively. after multivariable adjustment,the mean (95% ci) cost difference comparing participants with 5 to 7 versus 0 to 1 ideal ls7 factors was -$2551 (-$3667,-$1435) for inpatient,-$2410 (-$3089,-$1731) for outpatient,and -$5016 (-$6577,-$3454) for total expenditures. conclusions-better cardiovascular health is associated with lower risk for inpatient encounters and lower inpatient and outpatient healthcare expenditures. © 2017 the authors.