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. 2025 Jan 23;25(1):290.
doi: 10.1186/s12889-025-21489-x.

Relationship between handgrip strength and timed up-and-go test on hospitalization costs in older adults: a population-based study

Kevin Yiqiang Chua  1 , Kelvin Bryan Tan  2   3 , Rachel Tong  2 , Jon Barrenetxea  4 , Woon-Puay Koh  5   6 , Cynthia Chen  7   8   9
Affiliations

Relationship between handgrip strength and timed up-and-go test on hospitalization costs in older adults: a population-based study

Kevin Yiqiang Chua et al. BMC Public Health. .

Abstract

Background: Weak handgrip strength and slow timed up-and-go (TUG) time are known risk factors for hospitalization among older adults; however, few studies have investigated the relationships between these physical tests and future hospitalization costs.

Methods: We used data from 13,613 participants in the population-based Singapore Chinese Health Study who underwent assessment for handgrip strength and TUG time at a mean age of 74 years. Hospitalization costs for the subsequent year, among those who survived for at least one year thereafter, were ascertained via linkage with administrative healthcare finance data. We analyzed costs using a two-part model that contained a probit regression model in the first part, and a generalized linear regression model with gamma distribution and log link in the second.

Results: Handgrip strength showed a dose-dependent inverse relationship with hospitalization costs (Ptrend<0.001). Compared to the strongest quartile, participants in the weakest quartile experienced a 38.2% (95% CI: 18.0-58.5%) increase of US$599 (US$281-US$917) in mean costs. Conversely, TUG time demonstrated a dose-dependent positive association with hospitalization costs (Ptrend<0.001). Compared to the fastest quartile, participants in the slowest quartile had a 103.0% (72.1-133.9%) increase of US$1431 (US$1002-US$1859) in mean costs. We then examined combinations of handgrip strength and TUG time. Compared to participants who were both strong and fast, participants who were either weak or slow only had 12.9-48.7% higher mean costs. Meanwhile, participants who were both weak and slow experienced a 99.9% (68.5-131.4%) increase of US$1630 (US$1116-US$2144) in mean costs.

Conclusions: Weak handgrip strength and slow TUG time were independently associated with increased hospitalization costs among older adults.

Keywords: Cost; Expenditure; Grip; Healthcare; Muscle; Performance; Physical; Strength; TUG; Timed-up-and-go.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: This study was approved by the Institutional Review Board at the National University of Singapore. Written informed consent was obtained from all study participants. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

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References

    1. Global Burden of Disease Health Financing Collaborator Network. Future and potential spending on health 2015-40: development assistance for health, and government, prepaid private, and out-of-pocket health spending in 184 countries. Lancet. 2017;389(10083):2005–30. 10.1016/S0140-6736(17)30873-5 - PMC - PubMed
    1. Wammes JJG, van der Wees PJ, Tanke MAC, Westert GP, Jeurissen PPT. Systematic review of high-cost patients’ characteristics and healthcare utilisation. BMJ Open. 2018;8(9):e023113. 10.1136/bmjopen-2018-023113 - PMC - PubMed
    1. Ng SHX, Rahman N, Ang IYH, Sridharan S, Ramachandran S, Wang DD, et al. Characterising and predicting persistent high-cost utilisers in healthcare: a retrospective cohort study in Singapore. BMJ Open. 2020;10(1):e031622. 10.1136/bmjopen-2019-031622 - PMC - PubMed
    1. Bodenheimer T, Fernandez A. High and rising health care costs. Part 4: can costs be controlled while preserving quality? Ann Intern Med. 2005;143(1):26–31. 10.7326/0003-4819-143-1-200507050-00007 - PubMed
    1. Blumenthal D, Chernof B, Fulmer T, Lumpkin J, Selberg J. Caring for High-Need, high-cost patients - an Urgent Priority. N Engl J Med. 2016;375(10):909–11. 10.1056/NEJMp1608511 - PubMed

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