Can Physical Activity Reduce Health Care Utilization and Cost?

Background/Purpose: Physical activity (PA) is proven to have numerous positive health effects. However, little is known about the relationship between PA and health care utilization and in particular if PA translates into reduced demand for health services and subsequently, lower health care costs for adults. PA is a positive self-care behavior that could reduce the need for professional help seeking by improving overall physical health. On the other hand, adults with high levels of PA may seek more preventive and primary care. The objective of this study was to examine the association between level of PA and health care utilization and expenditure in seven specific services categories.

Methods: Data from the Household Component of Medical Expenditure Panel Survey (MEPS-HC) 2007 thru 2011 (n=95,426) were utilized. A binary indicator of regular PA was measured by asking whether participants spend half an hour or more in physical activity at least three times a week. Self-report measure of healthcare utilization and expenditures were examined in seven service categories: preventive (10 measures of preventive services recommended by the U.S. Preventive Services Task Force, e.g, colorectal cancer screening for people aged 50 and older, mammogram for women, etc), office-based, outpatient, emergency department, inpatient, home health, and prescription medicines. Logistic regression models were estimated for binary response variables. Negative binomial models were fitted for total number of visits among participants for each service category. Generalized linear model (GLM) with a gamma distribution using a log link was applied to compare total expenditure among service users by PA level. All models were estimated using Stata 11.0 to account for the complex survey design of the MEPS-HC, adjusted for BMI, gender, age, self-rated health, smoking status, disabilities, mental health, health beliefs, poverty level, insurance, and physical comorbidities.

Results: Regular PA was associated with increased odds of utilization of all 10 preventive services (ORs ranged from 1.07 to 1.39, p<.001) and office-based care (OR=1.06, p=.02). As well, adults who engaged in regular PA were less likely to use emergent care (OR=.94, p=.02), inpatient care (OR=0.82, p<.001), and home health (OR=0.67, p<.001). Among participants who utilized services in the past year, adults who engaged in regular PA had less overnight hospital stays (IRR=.88, p<.01) and home health days (IRR=.83, p=.04). They also spent 9% less on outpatient care and 10% less on inpatient care (p<.05).

Conclusions/Implications: Regular PA was correlated with increased utilization of preventive and primary care, and decreased utilization of inpatient care, home health and emergent care. Regular PA also appears to reduce health care expenditures. Generally, inpatient, home health, and emergent care are costly and less desirable for the individuals and society. Our findings suggest promoting regular physical activity as a potential way to reduce demand for these costly health services.