Physically active people use medical services less

People who regularly engage in physical activity are less likely to go to the doctor, emergency room or hospital, UW Medicine study finds.

Patients who reported that their physical activity met levels recommended by national guidelines were less likely to visit a primary care doctor, go to an emergency room or be admitted to hospital, researchers at the University of Washington School of Medicine report.

“We know that being physically active is good for health in countless ways, but what wasn’t well understood is how much being active impacts healthcare visits, specifically high-cost visits such as emergency department and inpatient hospital stays,” said Dr. Cindy Lin, clinical associate professor of rehabilitation medicine in the field of sports and spine medicine, and asssociate director of clinical innovation at the UW Sports Institute. She is the lead author of the study.

The findings were published Dec. 6 in the Journal of Physical Activity and Health.

“With this study, we finally have an understanding of how being physically active impacts healthcare utilization,” Lin said.

The researchers reviewed data collected on nearly 24,000 patients of the UW Medicine health care system.  As part of their clinic visits, they answered two simple questions about their level of physical activity. The questions, called the Physical Activity Vital Sign (PAVS), are designed to be easily incorporated into a routine office visit, like other vital signs, such as a patient’s temperature, heart rate and blood pressure. The survey asks: 

  • “How many days a week of moderately strenuous exercise (like a brisk walk that makes breathing harder than normal) do you do?” and 
  • “On average, each time you exercise, how many minutes do you exercise at this level?” 

For the study, patients who exercised 0 to 10 minutes a week were categorized as inactive, those who exercised 11 to 149 minutes a week as insufficiently active, and those who exercised 150 minutes or more a week (as recommended by U.S. Department of Health and Human Services’ guidelines) as sufficiently active. The patients’ responses to PAVS indicated that 28.5% were inactive; 34.1%, insufficiently active; and 37.4%, sufficiently active. 

The researchers found that, compared to inactive patients, active patients were significantly less likely to visit a primary care doctor, go to the emergency room or require hospitalization. Active patients, for example, had on average 34 fewer emergency room visits,19 fewer hospital admissions, and 38 fewer primary-care visits per 1,000 patient-years.

“People who are more physically active use less emergency room and inpatient hospitalization visits. This even when controlling for the patient's sex, race/ethnicity, and BMI [Body Mass Index],” said Lin.“More importantly, for those who are older or have more medical conditions, the association between being more physically active and lower use of high-cost healthcare visits is even stronger, making it even more important for those populations to be active.”

The findings suggest that increasing physical activity among patients could substantially reduce the nation’s health care costs, the researchers note. With the average cost of an emergency room visit exceeding $1,000, the researchers estimated that if inactive patients were to meet the physical activity guidelines of 150 minutes of moderate to vigorous activity, they would lower health-care costs by $34,500 per 1,000 patient-years for emergency department visits alone.

“We need to do better at supporting patients by not only prescribing pills to manage their conditions but also helping them be more active by prescribing exercise," said Lin. “No drug has the benefits that the ‘exercise pill’ can have on our health and across so many different conditions with minimal side effects at the correct dose. We should be asking every patient about physical activity as a vital sign at every outpatient visit and prescribing it to every patient.”

Statistician Andrew Humbert, assistant professor of rehabilitation medicine; Dr. Nicole Gentile, assistant professor of family medicine; UW medical student Valerie McDonald; and Trever Ball, director of clinical research at Northwell Health in New Hyde Park, N.Y. were co-authors on the paper.

No funding or conflicts of interest were reported for this study.

Written by Michael McCarthy

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