The Effects of an 18-Month Walking Habit Intervention on Reducing the Medical Costs of Diabetes, Hypertension, and Hyperlipidemia—A Prospective Study

Abstract

Chronic diseases such as diabetes, hypertension, and hyperlipidemia increase the medical costs for middle-aged and elderly people, thus requiring preventive intervention. Monitoring, maintaining, or increasing the number of steps walked per day could be expected to effectively reduce medical costs. We evaluated the medical costs for chronic diseases after the implementation of a step count monitoring system with an information communication technology that we hypothesized would efficiently decrease medical costs. We enrolled 342 subjects in the intervention group. An additional 1,025 subjects were selected as controls by matching with the intervention group for age, gender, and total medical costs accumulated in the year prior to the study. The subjects in the intervention group were provided with pedometers that were used with reading devices stationed throughout the city. The duration of the intervention was 18 months. The subjects were given health points based on their activity performance improvements such as the number of steps they walked. The medical costs for the 18 months before and afer the intervention were compared. The effect of cost reduction was evaluated by comparing the percent increase in medical cost from before to after intervention between the control group and the intervention group. After the intervention period, the medical costs increased in the control group but not in the intervention group. The step counts for the first three months and the last three months of the intervention period were assessed, and the results showed that an average step count of 8000 steps was maintained throughout the intervention period. Assuming that the control group showed a natural increase in medical costs, the results suggest that the natural increase in medical costs was suppressed in the intervention group during the intervention period as a result of using the pedometer technology and health points. Therefore, we found that encouraging the participants to proactively participate in walking was an effective strategy.