Medical costs of insufficient physical activity in middle-aged Chinese inpatients: Results from 2004 to 2021

Background: Insufficient physical activity has caused substantial medical costs, yet little is known about the longitudinal changes in medical costs of insufficient physical activity.
Purpose: The aim of this study was to examine the changes in medical costs of insufficient physical activity in middle-aged (≥ 45 years old) Chinese inpatients from 2004 to 2021.
Methods: The medical cost of insufficient physical activity each single year was assessed using the population attributable fraction (PAF) approach. First, the adjusted relative risks of coronary heart disease, stroke, type 2 diabetes, breast cancer, and colon cancer associated with insufficient physical activity were extracted from the published literature. Then, the medical cost of each noncommunicable disease (NCD) was calculated as a product of PAF%, the number of inpatients with a given NCD, and the average medical expenditure per inpatient. For this purpose, data on the number of inpatients with a given NCD and average medical expenditure per inpatient were extracted from the 2019 Chinese National Healthcare Annual Report. Finally, the changes in medical costs of insufficient PA were assessed using the linear regression model.
Results: There were significant increases in medical cost of insufficient physical activity in middle-aged Chinese inpatients (from Chinese Yuan 0.19 billion in 2004 to 14.98 billion in 2021, p for trend < 0.01), demonstrating a linearly increasing trend in changes of medical costs of insufficient physical activity in middle-aged Chinese inpatients from 2004 to 2021. The cost of cancer associated with insufficient physical activity accounted for the largest across all the targeted NCDs.
Conclusions: This study shows substantial medical costs of insufficient physical activity and further highlights the public health importance of encouraging middle-aged adults to participate in more physical activity.