Prospective association between late-life physical activity and hospital care utilisation: a 7-year nationwide follow-up study

Ku, Po-Wen; Steptoe, Andrew; Chen, Yi Huei; Chen, Li Jung; Lin, Ching Heng

doi:10.1093/ageing/afw202

Cited by 7 publications

(6 citation statements)

References 25 publications

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“…Our results are in line with other econometric studies, which also found that higher levels of physical activity were associated with lower healthcare use or costs in population based samples [15,16,21,22]. Ku et al and Carlson et al also reported similar percentage differences in healthcare expenditure.…”

Section: Strengths and Limitations Of The Studysupporting

confidence: 92%

“…Ku et al and Carlson et al also reported similar percentage differences in healthcare expenditure. [16,22] Karl et al used objective measures of physical activity in addition to self-reported physical activity, although the accelerometer data were only available for a subsample. [16] The authors reported that the accelerometer measured physical activity affected healthcare costs but no effect was found for the association with self-reported physical activity in line with our findings, in a comparable sample of European adults aged 48 to 68 years old.…”

Section: Strengths and Limitations Of The Studymentioning

confidence: 99%

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Inpatient care utilisation and expenditure associated with objective physical activity: econometric analysis of the UK Biobank

et al. 2022

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Background Physical inactivity increases the risk of chronic disease and mortality. The high prevalence of physical inactivity in the UK is likely to increase financial pressure on the National Health Service. The UK Biobank Study offered an opportunity to assess the impact of physical inactivity on healthcare use and spending using individual-level data and objective measures of physical activity. The objective of this study was to assess the associations between objectively measured physical activity levels and future inpatient days and costs in adults in the UK Biobank study. Methods We conducted an econometric analysis of the UK Biobank study, a large prospective cohort study. The participants (n = 86,066) were UK adults aged 43–79 who had provided sufficient valid accelerometer data. Hospital inpatient days and costs were discounted and standardised to mean monthly values per person to adjust for the variation in follow-up times. Econometric models adjusted for BMI, long-standing illness, and other sociodemographic factors. Results Mean follow-up time for the sample was 28.11 (SD 7.65) months. Adults in the most active group experienced 0.037 fewer days per month (0.059–0.016) and 14.1% lower inpatient costs ( – £3.81 [ – £6.71 to – £0.91] monthly inpatient costs) compared to adults in the least active group. The relationship between physical activity and inpatient costs was stronger in women compared to men and amongst those in the lowest income group compared to others. The findings remained significant across various sensitivity analyses. Conclusions Increasing physical activity levels in the UK may reduce inpatient hospitalisations and costs, especially in women and lower-income groups.

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Section: Strengths and Limitations Of The Studysupporting

confidence: 92%

Section: Strengths and Limitations Of The Studymentioning

confidence: 99%

Inpatient care utilisation and expenditure associated with objective physical activity: econometric analysis of the UK Biobank

et al. 2022

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“…However, many research findings indicate that individuals are likely to reduce their healthcare utilization as they become older [ 24 , 25 ]. Although positive relationships between age and healthcare demand have also been found [ 26 ]. Older adults expect healthcare to be comprehensive, desiring psychological and emotional care more than physical attention [ 27 ].…”

Section: Discussionmentioning

confidence: 99%

“…A higher value in BMI in women probably would indicate their vulnerability to chronic diseases such as hypertension and diabetes. In the literature, it has been shown that gender is a strong predisposing factor that influences healthcare utilization, and females are more likely than males to seek healthcare, especially in their later life [ 16 , 26 ]. In Sri Lanka, females outlive males, and older women experience greater ill health and loss of activities of daily living as they age [ 23 ].…”

Section: Discussionmentioning

confidence: 99%

Associated factors of doctor visits made by urban-dwelling older adults in Sri Lanka: an application of Anderson’s model of health service utilization

2022

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Background Although universal free healthcare is available for all Sri Lankan citizens, older adults face somewhat unique obstacles when utilizing available healthcare services. The aim of this study was to examine some vital predisposing, enabling, and need factors associated with doctor visits made by urban-dwelling older adults in Sri Lanka. Methods A representative sample of 880 urban-dwelling older adults (aged 60 years and above) was surveyed using an interviewer-administered questionnaire. Number of doctor visits, self-rated health, physical activity, and socio-demographic and self-report health conditions were collected. The data were analyzed using chi-squared tests and multinomial logistic regression. Results Participants’ mean age was 70.01 (± 6.02) years. The majority was women (75.0%). The mean number of doctor visits was 6.77 (± 5.92) per year. Nearly half of the participants (47.0%) had made, on average, at least one doctor visit per month. Older men and those of aged 80 years and above were the least likely to make frequent doctor visits. Participants who were physically active and who rated their health as poor were more likely to make frequent doctor visits after adjustment for age, gender, and educational level. Conclusions Doctor visits made by Sri Lankan older adults are satisfactory. The factors that best explain high frequency of doctor visits by older adults are female gender, younger age, higher physical activity and poor self-rated health. Attention should be paid to examine possible accessible and affordable issues related to doctor visits by bedridden or physically dependent older adults in advanced age categories.

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“…These non-disease specific outcome measures can be used to examine the overall level of health service usage [20]. Ageing populations put ever-increasing pressure on health care services and it is therefore important to establish if modest differences in modifiable lifestyle behaviours such as physical activity are related to hospitalisation [21][22][23][24].…”

Section: Introductionmentioning

confidence: 99%

Usual physical activity and subsequent hospital usage over 20 years in a general population: the EPIC-Norfolk cohort

et al. 2020

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Background: While physical activity interventions have been reported to reduce hospital stays, it is not clear if, in the general population, usual physical activity patterns may be associated with subsequent hospital use independently of other lifestyle factors. Objective: We examined the relationship between reported usual physical activity and subsequent admissions to hospital and time spent in hospital for 11,228 men and 13,786 women aged 40-79 years in the general population. Methods: Participants from a British prospective population-based cohort study were followed for 20 years (1999-2019) using record linkage to document hospital usage. Total physical activity was estimated by combining workplace and leisure time activity reported in a baseline lifestyle questionnaire and repeated in a subset at a second time point approximately 12 years later.Results: Compared to those reporting no physical activity, participants who were the most active had a lower likelihood of spending more than 20 days in hospital odds ratio (OR) 0.88 (95% confidence interval (CI) 0.81-0.96) over the next 20 years after multivariable adjustment for age, sex, smoking status, education, social class and body mass index. Participants reporting any activity had a mean of 0.42 fewer hospital days per year between 1999 and 2009 compared to inactive participants, an estimated potential saving to the National Health Service (NHS) of £247 per person per year, or approximately 7% of UK health expenditure. Participants who remained physically active or became active 12 years later had lower risk of subsequent hospital usage than those who remained inactive or became inactive, p-trend < 0.001. Conclusion: Usual physical activity in this middle-aged and older population predicts lower future hospitalisationstime spent in hospital and number of admissions independently of behavioural and sociodemographic factors. Small feasible differences in usual physical activity in the general population may potentially have a substantial impact on hospital usage and costs.

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Prospective association between late-life physical activity and hospital care utilisation: a 7-year nationwide follow-up study

Abstract: Background: It is still equivocal whether there is a potential role of late-life physical activity in

Cited by 7 publications

References 25 publications

Inpatient care utilisation and expenditure associated with objective physical activity: econometric analysis of the UK Biobank

Inpatient care utilisation and expenditure associated with objective physical activity: econometric analysis of the UK Biobank

Associated factors of doctor visits made by urban-dwelling older adults in Sri Lanka: an application of Anderson’s model of health service utilization

Usual physical activity and subsequent hospital usage over 20 years in a general population: the EPIC-Norfolk cohort

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