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.
Subject(s)
Delivery of Health Care , Exercise , Humans , Health Care Costs , Sedentary Behavior , Health FacilitiesABSTRACT
Patients treated for vulvar carcinoma may experience losses in mobility and physical activity. In this study, we assess the prevalence and severity of mobility problems using patient-reported outcomes of three questionnaires: EQ-5D-5L to estimate QoL and perceived health; SQUASH to estimate habitual physical activity; and a problem-specific questionnaire on bicycling. Patients treated for vulvar carcinoma between 2018 and 2021 were recruited, and 84 (62.7%) responded. The mean age was 68 ± 12 years (mean ± standard deviation). Self-reported QoL and perceived health were 0.832 ± 0.224 and 75.6 ± 20.0, respectively. Dutch physical activity guidelines were met by 34.2% of participants. Compared to baseline values, the times spent walking, bicycling, and participating in sports were all reduced. During bicycling, patients experienced moderate or severe pain in the skin of the vulva (24.5%), pain in the sit bones (23.2%), chafing (25.5%), or itching (8.9%). Overall, 40.3% experienced moderate or severe bicycling problems or could not bicycle, 34.9% felt that their vulva impeded bicycling, and 57.1% wished to make more or longer bicycling journeys. To conclude, vulvar carcinoma and its treatment reduce self-reported health, mobility, and physical activity. This motivates us to investigate ways to reduce discomfort during physical activities, and help women regain their mobility and self-reliance.
ABSTRACT
Recently, new physical activity (PA) guidelines were adopted in the Netherlands consisting of two components: (1) addressing duration of moderate and vigorous PA, (2) bone and muscle strengthening activities. The aim of this study is to retrospectively assess the long-term trend in fulfilling the criteria of the new PA guidelines and to gain insight into which activities contribute to changes over time. Data were available for 2001-2018 of a nationally representative sample of approximately 7000 Dutch citizens aged 12 years and over using the Short Questionnaire to Assess Health-enhancing physical activity (SQUASH). Multiple logistic regression analysis was performed by age, sex, and level of education. Overall, a positive trend was found from 39.9% adherence in 2001 to 46.0% in 2018. Adherence levels among adolescents decreased and increased among adults and seniors. Intermediate and higher educated groups showed positive trends over time whereas a stable trend was observed among lower educated. Activities contributing most to changes over time were sports, leisure time walking, and strenuous occupational activities. In the period 2001-2018, though an increasing trend was found, less than half of the population was sufficiently active. Special effort is necessary to reach adolescents, seniors, and lower educated groups in PA promotion programs.
