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BMC Health Services Research
Published in: BMC Health Services Research 1/2023

Open Access 01-12-2023 | Research

Impact of physical activity on healthcare costs: a systematic review

Authors: Marjolein Duijvestijn, G. Ardine de Wit, Paul F. van Gils, G. C. Wanda Wendel-Vos

Published in: BMC Health Services Research | Issue 1/2023

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Abstract

Background

This systematic review aims to describe the relation between physical inactivity and healthcare costs, by taking into account healthcare costs of physical-inactivity-related diseases (common practice), including physical-activity-related injuries (new) and costs in life-years gained due to avoiding diseases (new), whenever available. Moreover, the association between physical inactivity and healthcare costs may both be negatively and positively impacted by increased physical activity.

Methods

A systematic review was conducted, including records reporting on physical (in)activity in relation to healthcare costs for a general population. Studies were required to report sufficient information to calculate the percentage of total healthcare costs potentially attributable to physical inactivity.

Results

Of the 264 records identified, 25 were included in this review. Included studies showed substantial variation in the assessment methods of physical activity and in type of costs included. Overall, studies showed that physical inactivity is related to higher healthcare costs. Only one study included costs of healthcare resources used in prolonged life when physical-inactivity-related diseases were averted, showing net higher healthcare costs. No study included healthcare costs for physical-activity-related injuries.

Conclusions

Physical inactivity is associated with higher healthcare costs in the general population in the short-term. However, in the long-term aversion of diseases related with physical inactivity may increase longevity and, as a consequence, healthcare costs in life-years gained. Future studies should use a broad definition of costs, including costs in life-years gained and costs related to physical-activity-related injuries.
Appendix
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Literature
1.
Guthold R, Stevens GA, Riley LM, Bull FC. Worldwide trends in insufficient physical activity from 2001 to 2016: a pooled analysis of 358 population-based surveys with 1· 9 million participants. Lancet Glob Health. 2018;6(10):e1077–86.PubMedCrossRef
2.
Bull FC, Al-Ansari SS, Biddle S, Borodulin K, Buman MP, Cardon G, et al. World Health Organization 2020 guidelines on physical activity and sedentary behaviour. Br J Sports Med. 2020;54(24):1451-62.
3.
Lee I-M, Shiroma EJ, Lobelo F, Puska P, Blair SN, Katzmarzyk PT, et al. Effect of physical inactivity on major non-communicable diseases worldwide: an analysis of burden of disease and life expectancy. Lancet. 2012;380(9838):219–29.PubMedPubMedCentralCrossRef
4.
Wendel-Vos G, Schuit A, Feskens E, Boshuizen H, Verschuren W, Saris W, et al. Physical activity and stroke. A meta-analysis of observational data. Int J Epidemiol. 2004;33(4):787–98.PubMedCrossRef
5.
Blair SN, Connelly JC. How much physical activity should we do? The case for moderate amounts and intensities of physical activity. Res Q Exerc Sport. 1996;67(2):193–205.PubMedCrossRef
6.
Pawlowski T, Downward P, Rasciute S. Subjective well-being in European countries—on the age-specific impact of physical activity. Eur Rev Aging Phys Act. 2011;8(2):93–102.CrossRef
7.
Bailey R, Hillman C, Arent S, Petitpas A. Physical activity: an underestimated investment in human capital? J Phys Act Health. 2013;10(3):289–308.PubMedCrossRef
8.
Ding D, Lawson KD, Kolbe-Alexander TL, Finkelstein EA, Katzmarzyk PT, van Mechelen W, et al. The economic burden of physical inactivity: a global analysis of major non-communicable diseases. Lancet. 2016;388(10051):1311–24.PubMedCrossRef
9.
Ding D, Kolbe-Alexander T, Nguyen B, Katzmarzyk PT, Pratt M, Lawson KD. The economic burden of physical inactivity: a systematic review and critical appraisal. Br J Sports Med. 2017;51(19):1392–409.PubMedCrossRef
10.
van Baal PHM, Polder JJ, de Wit GA, Hoogenveen RT, Feenstra TL, Boshuizen HC, et al. Lifetime medical costs of obesity: prevention no cure for increasing health expenditure. PLoS Med. 2008;5(2): e29.PubMedPubMedCentralCrossRef
11.
Barendregt JJ, Bonneux L, van der Maas PJ. The health care costs of smoking. NEJM. 1997;337(15):1052–7.PubMedCrossRef
12.
van Baal PH, Feenstra TL, Polder JJ, Hoogenveen RT, Brouwer WB. Economic evaluation and the postponement of health care costs. Health Econ. 2011;20(4):432–45.PubMedCrossRef
13.
de Vries LM, van Baal PH, Brouwer WB. Future costs in cost-effectiveness analyses: past, present, future. Pharmacoeconomics. 2019;37(2):119–30.PubMedCrossRef
14.
Sanders GD, Neumann PJ, Basu A, Brock DW, Feeny D, Krahn M, et al. Recommendations for conduct, methodological practices, and reporting of cost-effectiveness analyses: second panel on cost-effectiveness in health and medicine. JAMA. 2016;316(10):1093–103.PubMedCrossRef
15.
16.
Polinder S, Haagsma J, Panneman M, Scholten A, Brugmans M, Van Beeck E. The economic burden of injury: Health care and productivity costs of injuries in the Netherlands. Accid Anal Prev. 2016;93:92–100.PubMedCrossRef
17.
Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis JP, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. J Clin Epidemiol. 2009;62(10):e1–34.PubMedCrossRef
18.
Holtermann A, Hansen J, Burr H, Søgaard K, Sjøgaard G. The health paradox of occupational and leisure-time physical activity. Br J Sports Med. 2012;46(4):291–5.PubMedCrossRef
19.
20.
21.
Husereau D, Drummond M, Petrou S, Carswell C, Moher D, Greenberg D, et al. Consolidated health economic evaluation reporting standards (CHEERS) statement. Cost Eff Resour. 2013;11(1):6.CrossRef
22.
Aljadhey H. Physical inactivity as a predictor of high prevalence of hypertension and health expenditures in the United States: A cross-sectional study. Trop J Pharm Res. 2012;11(6):983–90.
23.
Aoyagi Y, Shephard RJ. A Model to Estimate the Potential for a Physical Activity-Induced Reduction in Healthcare Costs for the Elderly, Based on Pedometer/Accelerometer Data from the Nakanojo Study. Sports Med. 2011;41(9):695–708.PubMedCrossRef
24.
Carlson SA, Fulton JE, Pratt M, Yang Z, Adams EK. Inadequate Physical Activity and Health Care Expenditures in the United States. Prog Cardiovasc Dis. 2015;57(4):315–23.PubMedCrossRef
25.
Chevan J, Roberts DE. No short-term savings in health care expenditures for physically active adults. Prev Med. 2014;63:1–5.PubMedCrossRef
26.
Dallmeyer S, Wicker P, Breuer C. The relationship between physical activity and out-of-pocket health care costs of the elderly in Europe. Eur J Public Health. 2020;30(4):628–32.PubMedCrossRef
27.
de Boer WIJ, Dekker LH, Koning RH, Navis GJ, Mierau JO. How are lifestyle factors associated with socioeconomic differences in health care costs? Evidence from full population data in the Netherlands. Prev Med. 2020;130:105929.
28.
Kalbarczyk M, Mackiewicz-Łyziak J. Physical Activity and Healthcare Costs: Projections for Poland in the Context of an Ageing Population. Appl Health Econ. 2019;17(4):523–32.CrossRef
29.
Kang SW, Xiang X. Physical activity and health services utilization and costs among US adults. Prev Med. 2017;96:101–5.
30.
Karl FM, Tremmel M, Luzak A, Schulz H, Peters A, Meisinger C, et al. Direct healthcare costs associated with device assessed and self-reported physical activity: results from a cross-sectional population-based study. BMC Public Health. 2018;18(1):966.PubMedPubMedCentralCrossRef
31.
Min JY, Min KB. Excess medical care costs associated with physical inactivity among Korean adults: retrospective cohort study. Int J Environ Res Public Health. 2016;13(1):136.
32.
Peeters GMEE, Mishra GD, Dobson AJ, Brown WJ. Health care costs associated with prolonged sitting and inactivity. Am J Prev Med. 2014;46(3):265–72.PubMedCrossRef
33.
Peeters GMEE, Gardiner PA, Dobson AJ, Brown WJ. Associations between physical activity, medical costs and hospitalisations in older Australian women: Results from the Australian Longitudinal Study on Women’s Health. J Sci Med Sport. 2018;21(6):604–8.PubMedCrossRef
34.
Sato M, Du J, Inoue Y, Funk DC, Weaver F. Older Adults’ Physical Activity and Healthcare Costs, 2003–2014. Am J Prev Med. 2020;58(5):e141–8.PubMedCrossRef
35.
Yang G, Niu K, Fujita K, Hozawa A, Ohmori-Matsuda K, Kuriyama S, et al. Impact of physical activity and performance on medical care costs among the Japanese elderly. Geriatr Gerontol Int. 2011;11(2):157–65.PubMedCrossRef
36.
Amarasinghe AK. Cost-effectiveness implications of GP intervention to promote physical activity: Evidence from Perth. Australia Cost Eff Resour. 2010;8(1):1–6.
37.
38.
39.
Janssen I. Health care costs of physical inactivity in Canadian adults. Appl Physiol. 2012;37(4):803–6.
40.
Krueger H, Krueger J, Koot J. Variation across Canada in the economic burden attributable to excess weight, tobacco smoking and physical inactivity. Can J Public Health. 2015;106(4):e171–7.PubMedPubMedCentralCrossRef
41.
Krueger H, Koot JM, Rasali DP, Gustin SE, Pennock M. Regional variations in the economic burden attributable to excess weight, physical inactivity and tobacco smoking across British Columbia. Health Promot Chronic Dis Prev Can. 2016;36(4):76–86.PubMedPubMedCentralCrossRef
42.
Mattli R, Wieser S, Probst-Hensch N, Schmidt-Trucksäss A, Schwenkglenks M. Physical inactivity caused economic burden depends on regional cultural differences. Scand J Med Sci Sports. 2019;29(1):95–104.PubMedCrossRef
43.
Maresova K. The costs of physical inactivity in the Czech republic in 2008. J Phys Act Health. 2014;11(3):489–94.PubMedCrossRef
44.
45.
Scarborough P, Bhatnagar P, Wickramasinghe KK, Allender S, Foster C, Rayner M. The economic burden of ill health due to diet, physical inactivity, smoking, alcohol and obesity in the UK: An update to 2006–07 NHS costs. J Public Health. 2011;33(4):527–35.CrossRef
46.
Krueger H, Andres EN, Koot JM, Reilly BD. The economic burden of cancers attributable to tobacco smoking, excess weight, alcohol use, and physical inactivity in Canada. Curr Oncol. 2016;23(4):241–9.PubMedPubMedCentralCrossRef
47.
48.
Arem H, Moore SC, Patel A, Hartge P, De Gonzalez AB, Visvanathan K, et al. Leisure time physical activity and mortality: a detailed pooled analysis of the dose-response relationship. JAMA Intern Med. 2015;175(6):959–67.PubMedPubMedCentralCrossRef
49.
50.
Sallis JF, Saelens BE. Assessment of physical activity by self-report: status, limitations, and future directions. Res Q Exerc Sport. 2000;71(sup2):1–14.PubMedCrossRef
51.
Lahti J, Lahelma E, Rahkonen O. Changes in leisure-time physical activity and subsequent sickness absence: a prospective cohort study among middle-aged employees. Prev Med. 2012;55(6):618–22.PubMedCrossRef
52.
Proper KI, Van den Heuvel S, De Vroome E, Hildebrandt V, Van der Beek A. Dose–response relation between physical activity and sick leave. Br J Sports Med. 2006;40(2):173–8.PubMedPubMedCentralCrossRef
53.
Metadata
Title
Impact of physical activity on healthcare costs: a systematic review
Authors
Marjolein Duijvestijn
G. Ardine de Wit
Paul F. van Gils
G. C. Wanda Wendel-Vos
Publication date
01-12-2023
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2023
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/s12913-023-09556-8

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