International journal of public health · 2026
Joint trajectories of health behaviors and their associations with healthcare utilization and expenditure.
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Yang Jeong Min, Kim Jang Mook, Jang Tae Su, Hwang Jieun
Аннотация
OBJECTIVES: This study identified sex-specific trajectories of key health behaviors among middle-aged and older adults and examined their longitudinal associations with healthcare utilization and expenditure.
METHODS: We analyzed 167,343 Korean adults aged 40-79 years from 2002 to 2019 using the National Health Insurance Service Health Screening Cohort. Group-based multi-trajectory modeling identified joint trajectories of smoking, alcohol consumption, physical activity, and BMI. Associations with healthcare outcomes were assessed using generalized estimating equations stratified by sex and age group.
RESULTS: Six distinct health behavior trajectories were identified in both sexes. Among men, the higher moderate-risk trajectory showed fewer outpatient visits but longer hospital stays. Among women, the higher severe-risk trajectory was associated with increased expenditures and higher healthcare utilization. Age-stratified analyses revealed stronger associations for severe-risk trajectories in men aged <65 years and lower severe-risk trajectories in those aged ≥65 years.
CONCLUSION: Sex- and age-specific behavioral trajectories were differentially associated with healthcare utilization and expenditure, underscoring the importance of multidimensional behavioral patterns in developing preventive strategies to reduce healthcare burdens.
METHODS: We analyzed 167,343 Korean adults aged 40-79 years from 2002 to 2019 using the National Health Insurance Service Health Screening Cohort. Group-based multi-trajectory modeling identified joint trajectories of smoking, alcohol consumption, physical activity, and BMI. Associations with healthcare outcomes were assessed using generalized estimating equations stratified by sex and age group.
RESULTS: Six distinct health behavior trajectories were identified in both sexes. Among men, the higher moderate-risk trajectory showed fewer outpatient visits but longer hospital stays. Among women, the higher severe-risk trajectory was associated with increased expenditures and higher healthcare utilization. Age-stratified analyses revealed stronger associations for severe-risk trajectories in men aged <65 years and lower severe-risk trajectories in those aged ≥65 years.
CONCLUSION: Sex- and age-specific behavioral trajectories were differentially associated with healthcare utilization and expenditure, underscoring the importance of multidimensional behavioral patterns in developing preventive strategies to reduce healthcare burdens.