Medical costs of a low skeletal muscle mass are modulated by dietary diversity and physical activity in community-dwelling older Taiwanese: a longitudinal study

Table 2 Multivariable generalized linear models for annual medical service utilization and expenditure stratified by high and low SMMI^a (n = 1337)

	Total (n = 1337)		Men (n = 689)		Women (n = 648)
	High risk	Low risk	High risk	Low risk	High risk	Low risk
n (%)	330 (24.7)	1007 (75.3)	171 (24.8)	518 (75.2)	159 (24.5)	489 (75.5)
Deceased (%)	165 (50.0)	305 (30.3)	90 (52.6)	183 (35.3)	75 (47.2)	122 (25.0)
Medical service utilization
Ambulatory care visits, times^b
Outpatient services	25.1 (21.9)^***	28.7 (24.6)	25.4 (22.3)	26.8 (23.7)	24.7 (21.7)^***	30.7 (25.3)
Preventive care	1.00 (0.93)	1.27 (1.16)	0.84 (0.82)	1.02 (0.98)	1.17 (1.08)	1.53 (1.46)
Dental services	0.65 (0.14)^***	1.03 (0.42)	0.74 (0.14)^***	1.11 (0.46)	0.56 (0.14)	0.94 (0.30)
Emergency	0.81 (0.31)^*	0.57 (0.28)	0.83 (0.39)^*	0.62 (0.29)	0.79 (0.29)	0.51 (0.27)
Hospitalization, days^b	13.6 (2.15)^***	7.13 (1.32)	16.0 (2.58)^***	9.03 (1.45)	10.9 (1.52)^***	5.12 (1.18)
Medical service expenditure, 1000 NT$^c
Ambulatory care^d
Outpatient services	20.8 (16.4)^**	25.9 (18.4)	23.2 (17.1)	26.0 (18.1)	18.3 (15.9)^*	25.7 (18.8)
Preventive care	0.21 (0.18)^*	0.28 (0.24)	0.18 (0.15)	0.23 (0.19)	0.25 (0.20)^*	0.34 (0.31)
Dental services	0.54 (0.07)^**	0.88 (0.29)	0.63 (0.06)^*	0.98 (0.36)	0.44 (0.07)	0.77 (0.24)
Emergency	2.80 (0.76)^**	1.70 (0.51)	2.74 (0.80)^**	1.77 (0.59)	2.87 (0.72)	1.62 (0.43)
Hospitalization^d	77.5 (10.6)^***	38.7 (6.89)	79.6 (12.2)^**	49.8 (8.03)	75.3 (6.50)^***	26.9 (5.86)
Total medical expenditure^d	102 (34.4)^***	67.4 (33.4)	106 (39.6)	78.8 (34.8)	97.2 (31.7)^**	55.4 (32.2)

^aThe high-risk group comprises participants with a lower SMMI (<11.4 kg/m² for men and 8.50 kg/m² for women). The low-risk group comprises participants with a normal SMMI and serves as a reference group
^bMean (median). Outcome was assessed using GLMs with Poisson distribution
^cNT$, with an exchange rate of approximately NT$31 to US$1 in 2017
^dMean (median). Outcomes was assessed using GLMs with gamma distribution
Models were adjusted for age, region of residence, ethnicity, education level, living status, self-reported financial status, household income (NT$/mo), perceived health status, ADL, CCI, energy (kcal/d), protein (g/d), DDS (≤4 or > 4), and physical activity (<1.5 MET/day or ≥ 1.5 MET/day)
^* P < 0.05, ^** P < 0.01, ^*** P < 0.001

ISSN: 1479-5868