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Cost-effectiveness of the promotion of physical activity in health care
Umeå University, Faculty of Medicine, Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
2007 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Introduction

Physical inactivity is a major cause of reduced quality of life, as well as many common diseases and even premature death. Most people, globally, are scarcely or rarely physically active. Consequently, physical inactivity influences the burden of disease, and increases its societal costs. In view of this, it is necessary to ask how health care should respond when the population and the patients are either inactive or rarely physically active. Cost-effectiveness analyses of the promotion of physical activity in health care can contribute substantially to health care policy.

Aims

The overall aim of this thesis was to investigate the cost-effectiveness of physical activity promotion in the health care system. The specific aims were: (I) to provide a model for analyzing cost-effectiveness and equity in health for community-promoted physical activity, (II) to review current knowledge about the cost-effectiveness of health care based interventions aimed at improving physical activity, (III) to evaluate the cost effectiveness of physical activity promotion as a treatment method in primary health care, (IV) to illustrate the importance of enjoyment of exercise in interventions aimed at promoting physical activity, and (V) to describe a method of valuing the time spent on exercise.

Methods

Standard methods for economic evaluation were studied and adapted to create a model for the evaluation of physical activity promotion (I). Relevant databases were searched for published articles, and the articles found were analyzed using this economic evaluation model (II). A trial in primary health care was evaluated in a cost-utility analysis based on the model (III). In the same trial, the association between time spent on exercise and enjoyment of exercise was analyzed (IV). A model for valuing the time spent on exercise was developed based on existing approaches to the valuation of time, and used in two different groups of exercisers; experienced and inexperienced (V).

Results

An economic evaluation model was developed, as was a model to calculate an intervention’s effect on equity in health (I). In total, 26 articles were found regarding the cost-effectiveness of physical activity promotion in health care, and 20 of these described interventions, which the authors considered to be cost-effective (II). The treatment of patients in primary health care by the promotion of physical activity was shown to be cost-effective (III). For the same group of patients, time spent on exercise was associated with enjoyment of exercise (IV). A model for valuing the time spent on exercise was developed and used. Time costs were significantly higher among inexperienced exercisers (V).

Conclusions

There are many examples of interventions promoting physical activity that may be regarded as cost-effective. In general, it seems to be cost effective to promote physical activity among patients with increased risk, or who manifest poor health associated with physical inactivity. Unfortunately, there is still little evidence of when physical activity should be used, or what the best design of such an intervention might be. Although there is still a need for stronger evidence, the Swedish health care system should use the promotion of physical activity as a standard method among the following patients:

• those who manifest increased risk (such as high blood pressure) of ill health due to a physically inactive lifestyle;

• frail older people, especially those with increased risk of fall injuries;

• those requiring rehabilitation after heart failure.

Place, publisher, year, edition, pages
Umeå: Folkhälsa och klinisk medicin , 2007. , 91 p.
Series
Umeå University medical dissertations, ISSN 0346-6612 ; 1085
Keyword [en]
physical activity promotion, cost-effectiveness, health care
Research subject
Epidemiology
Identifiers
URN: urn:nbn:se:umu:diva-999ISBN: 978-91-7264-259-1 (print)OAI: oai:DiVA.org:umu-999DiVA: diva2:145331
Public defence
2007-02-28, sal 135, 9A, NUS, UMEÅ, 09:00 (English)
Opponent
Available from: 2007-02-12 Created: 2007-02-12 Last updated: 2009-10-16Bibliographically approved
List of papers
1. Is promotion of physical activity a wise use of societal resources? Issues of cost-effectiveness and equity in health.
Open this publication in new window or tab >>Is promotion of physical activity a wise use of societal resources? Issues of cost-effectiveness and equity in health.
2005 (English)In: Scandinavian Journal of Medicine and Science in Sports, ISSN 0905-7188, E-ISSN 1600-0838, Vol. 15, no 5, 304-312 p.Article in journal (Refereed) Published
Keyword
Attitude to Health, Cost-Benefit Analysis, Health Behavior, Health Promotion/*economics, Humans, Models; Econometric, Motor Activity, Patient Compliance, Public Health
Identifiers
urn:nbn:se:umu:diva-13842 (URN)10.1111/j.1600-0838.2004.00415.x (DOI)16181254 (PubMedID)
Available from: 2007-05-16 Created: 2007-05-16 Last updated: 2017-12-14Bibliographically approved
2. Cost-effectiveness of healthcare-based interventions aimed at improving physical activity.
Open this publication in new window or tab >>Cost-effectiveness of healthcare-based interventions aimed at improving physical activity.
2006 (English)In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 34, no 6, 641-653 p.Article in journal (Refereed) Published
Keyword
Aged, Cost-Benefit Analysis, Evidence-Based Medicine, Exercise, Health Behavior, Health Promotion/*economics, Health Status, Heart Failure; Congestive/prevention & control, Humans, Life Style, Middle Aged, Models; Economic, Public Health/*economics, Risk Factors
Identifiers
urn:nbn:se:umu:diva-14137 (URN)10.1080/14034940600627853 (DOI)17132598 (PubMedID)
Available from: 2007-05-23 Created: 2007-05-23 Last updated: 2017-12-14Bibliographically approved
3. Cost-effectiveness analysis of the promotion of physical activity as a treatment method in primary health care
Open this publication in new window or tab >>Cost-effectiveness analysis of the promotion of physical activity as a treatment method in primary health care
Manuscript (Other academic)
Identifiers
urn:nbn:se:umu:diva-5714 (URN)
Available from: 2007-02-12 Created: 2007-02-12 Last updated: 2010-01-13Bibliographically approved
4. The importance of enjoyment of exercise in promoting physical activity
Open this publication in new window or tab >>The importance of enjoyment of exercise in promoting physical activity
Manuscript (Other academic)
Identifiers
urn:nbn:se:umu:diva-5715 (URN)
Available from: 2007-02-12 Created: 2007-02-12 Last updated: 2010-01-13Bibliographically approved
5. Time costs of exercise in interventions aimed at promoting physical activity
Open this publication in new window or tab >>Time costs of exercise in interventions aimed at promoting physical activity
Manuscript (Other academic)
Identifiers
urn:nbn:se:umu:diva-5716 (URN)
Available from: 2007-02-12 Created: 2007-02-12 Last updated: 2010-01-13Bibliographically approved

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