The economic implications of self-care: The effect of lifestyle, functional adaptations, and medical self-care among a national sample of medicare beneficiaries

Objectives. Self-care includes actions taken by individuals to promote or e nsure their health, to recover from diseases or injuries, or to manage thei r effects. This study measured associations between self-care practices (li festyle practices, adaptations to functional limitations, and medical self- care) and Medicare expenditures among a national sample of adults 65 years and older. Methods. Regression models of Medicare use and expenditures were estimated by using the National Survey of Self-Care and Aging and Medicare claims for 4 years following a baseline interview. Results. Lifestyle factors (swimming and walking) and functional adaptation s (general home modifications) were associated with reductions in monthly M edicare expenditures over a 12-month follow-up period. Expenditure reductio ns were found over the 48-month follow-up period for participation in activ e sports, gardening, and medical self-care. Practices associated with incre ases in expenditures included smoking, physical exercise (possibly of a mor e strenuous nature), and specific home modifications. Conclusions. Certain self-care practices appear to have significant implica tions for Medicare expenditures and presumptively for the health status of older adults. Such practices should be encouraged among older adults as a m atter of national health policy.