Regular exercise may decrease healthcare costs, utilization

Being physically active on a regular basis has been shown to improve people’s health and decrease their risk for cardiovascular disease. It also may help decrease healthcare costs and utilization.

An economic model based on survey data found that adults who engaged in at least 30 minutes of moderate to vigorous physical activity at least five times per week had lower healthcare expenditures and resource utilization compared with those who did not exercise as much.

Participants with cardiovascular disease who regularly exercised had mean healthcare costs more than $2,500 lower than those who did not exercise on a regular basis.

Lead researcher Javier Valero-Elizondo, MD, MPH, of Baptist Health South Florida in Miami, and colleagues published their results online in the Journal of the American Heart Association on Sept. 7.

­“Even among an established high-risk group such as those diagnosed with heart disease or stroke, those who engaged in regular exercise activities reported a much lower risk of being hospitalized, (having) an emergency room visit and use of prescription medications,” senior study author Khurram Nasir, MD, of Baptist Health South Florida, said in a news release.

The researchers evaluated 26,239 adults who were part of the 2012 Medical Expenditure Panel Survey (MEPS), a set of large-scale, national surveys run by the Agency for Healthcare Research and Quality.

They classified participants based on their answer to a survey question on whether they spent a half hour or more of moderate to vigorous physical activity at least five times per week. They defined moderate physical activity as causing light sweating or a slight to moderate increase in breathing or heart rate. Examples of moderate physical activity include fast walking, raking leaves, mowing the lawn or heavy cleaning.

Meanwhile, they defined vigorous physical activity as causing heavy swearing or large increases in breathing or heart rate. Examples of vigorous physical activity include running, race walking, lap swimming, aerobic classes or fast bicycling.

The researchers further identified participants based on the number of cardiovascular modifiable risk factors they had, including hypertension, diabetes, hypercholesterolemia, smoking and/or obesity. When calculating costs, they included expenditures from all payer groups and out-of-pocket spending.

The mean age of the participants was 47.6 years old, while 51.5 percent were females and 9 percent had cardiovascular disease. The researchers defined cardiovascular disease as the presence of coronary artery disease, stroke, heart failure, dysrhythmias and/or peripheral artery disease.

In addition, nearly half of participants without cardiovascular disease (49 percent) and 32 percent of participants with cardiovascular disease said they engaged in moderate to vigorous physical activity. Participants with optimal physical activity were less likely to have cardiovascular disease risk factors or comorbid conditions and more likely to have a better health and socioeconomic status.

The researchers mentioned that the presence of cardiovascular disease was independently associated with higher healthcare expenditures compared with adults who did not have cardiovascular disease. In addition, the presence of optimal physical activity was associated with lower expenditures and less use of healthcare resources regardless of whether adults had cardiovascular disease.

The researchers cited a few limitations of the study, including that participants self-reported their physical activity levels, cardiovascular disease status and modifiable cardiovascular risk factors. They also mentioned that the observational design of the study meant residual confounding might have affected the results. Further, previous analyses showed that the MEPS underestimated total medical expenditures.