The burden of physical inactivity and diabetes on primary care costs in Brazil

Background: Physical inactivity and diabetes have increased in the Brazilian population, while their economic burden is still unclear.
Purpose: To analyze the association between healthcare costs and the combination of physical inactivity and type 2 diabetes in Brazilian adults.
Methods: A cohort study, in which 771 adults were tracked from 2010 to 2020. Physical activity was assessed through face-to-face interviews using the Baecke questionnaire (physical inactivity was defined as a score <P75th), while diabetes was assessed through medical records. Healthcare costs (US$) were determined by expenditures paid by the Brazilian National Health Service, accessed by medical records, and expressed as median and interquartile range values. Comparisons between groups were analyzed using the Kruskal-Wallis test (p-value <5%).
Results: The median of healthcare costs accumulated from 2010 to 2020 by adults classified as Active + Non-diabetic was US$ 279.42 [287.61], while adults classified as inactive or diabetic accumulated US$ 227.80 [349.10], and adults classified as inactive + diabetic accumulated US$ 547.20 [976.20] (Kruskal-Wallis test, p-value= 0,001).
Conclusions: The combination of physical inactivity and diabetes seems to significantly increase healthcare costs in Brazil.
Practical implications: The combination of physical inactivity and diabetes increases primary healthcare costs among Brazilian adults by about 95%. The elimination and/or mitigation of at least one of these variables would lead to a significant economic relief to the Brazilian National Health Service.
Funding: FAPESP