Effect of Changes in Physical Activity on Medical Expenditure among South Korean Adults with Chronic Diseases

Abstract

Objectives Regular physical activity is a cost-effective way to enhance both physical and mental health without any side effects. Yet, among 5,820 Korean adults, 66.0% did not meet any of the physical activity guidelines. Due to the increasing proportion of elderly population and those conducting poor health behaviors, such as lack of exercises, the prevalence of chronic diseases is growing rapidly in South Korea. Nevertheless of the circumstances getting worse and economic burden increasing as a result, lack of researches scrutinized the effects of physical activity of patients with chronic diseases on medical expense. Therefore, this study aimed to examine the effect of changes in physical activity on medical expenses among South Korean adults with chronic diseases. Methods Data were included from the 2014, 2015, 2016, 2017 and 2018 Korea Health Panel Survey. The KHPS is conducted by a national institution based on 90% of the 2005 Population and Housing Census data as a sampling frame, and therefore, the national representation was maintained. “Changes in physical activity” was the main independent variable. Physical activity was categorized as one of the four status: increase, decrease, remained active, remained inactive. The dependent variable, medical expenditure, was calculated by the sum of outpatient medical expenses, hospitalization expenses, and emergency medical expenses. Generalized Estimating Equation was performed to examine target effect. Results Those who decreased physical activity compared to the previous year presented with a higher estimate of total medical cost compared to those who maintained regular physical activity. (decrease: estimate = 392269.40, p-value = 0.0174). More importantly, those who remained inactive resulted in highest total medical cost (remained inactive: estimate = 476968.60, p-value = 0.0005). Lastly, those started to perform regular physical activity did not show a statistically significant difference between those who always remained active. Conclusion This study suggests that every patient with chronic diseases to either start or continue to exercise and the government officials to develop chronic diseases management programs inducing patients to actively participate in physical activity, for both maintaining a healthy quality of life for the individual and minimizing excessive medical expenses.