Abstract
SummaryBetter management by individuals of their long‐term conditions is promoted to improve health and reduce healthcare expenditure. However, there is limited evidence on the determinants and consequences of self‐management activity. We investigate the determinants of two forms of self‐management, exercise and relaxation, and their impact on the health and wellbeing of 3472 individuals with long‐term health conditions over a 1‐year period. We use simultaneous recursive trivariate models to estimate the effects of these two inputs on three health and wellbeing outcomes: the EuroQol five‐dimensional (EQ‐5D) score, self‐assessed health and happiness. We reflect the opportunity cost of time and knowledge with employment status and education and find that employment reduces relaxation and education increases exercise. We find that neither exercise nor relaxation affects the EuroQol five‐dimensional score, but exercise increases self‐assessed health and relaxation increases happiness. Our findings show that individuals tailor their self‐management activities to their economic constraints, with effects on different aspects of their utility. Interventions to encourage self‐management should take account of heterogeneous effects and constraints. © 2017 The Authors. Health Economics Published by John Wiley & Sons, Ltd.
Highlights
Healthcare systems in Organisation for Economic Co-operation and Development (OECD) countries are endeavouring to rise to the challenges emerging from ageing populations, growing levels of chronic illness, advancing technical possibilities and rising public expectations
There is a similar trend across OECD countries; in 1990, average spending on long-term conditions was 0.7% of GDP, and this had risen to 1.5% of GDP by 2012 (Gershlick, 2015)
Our study is distinct because we study a population of individuals with long-term conditions, precisely those for whom self-management potential is greatest
Summary
Healthcare systems in Organisation for Economic Co-operation and Development (OECD) countries are endeavouring to rise to the challenges emerging from ageing populations, growing levels of chronic illness, advancing technical possibilities and rising public expectations. These challenges have resulted in healthcare expenditure growing more rapidly than GDP in all OECD countries over the past 30 years (Pammolli et al, 2011). In the UK, spending on the National Health Service (NHS) as a proportion of GDP is expected to fall from 8% to just over 6% by 2021 (Appleby et al, 2014) This could result in a funding gap of approximately £30 billion by 2020/21 (Illmann). There is a similar trend across OECD countries; in 1990, average spending on long-term conditions was 0.7% of GDP, and this had risen to 1.5% of GDP by 2012 (Gershlick, 2015)
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
