Abstract
ObjectivesTo assess domain-specific effects of physical activity (PA) in the relationship with health care utilization and to investigate whether a measure that aggregates PA across domains (leisure, transport, work) is appropriate.MethodsData were retrieved from a longitudinal cohort study conducted in Southern Germany (women n = 1330, men n = 766). The number of physician visits was regressed on total PA and on PA differentiated by the domains leisure time, travel time and working time in a negative binomial model.ResultsFor women, no association with physician visits is found for total PA, while high leisure time physical activity (LTPA) is associated with 22% more visits. The effect of high LTPA is statistically different from the effect of high total PA. For men, no significant associations are found for both measures.ConclusionsThe specific, positive effect of high LTPA on physician visits among women shows that using an aggregate measure of PA is inappropriate for analyzing the relation between PA and health care utilization. Further, the positive relationship should be considered in attempts to promote physical activity.
Highlights
Physical activity (PA) has been proven to be an important factor in the prevention of numerous chronical diseases (Bull et al 2004; Maruti et al 2008; Meisinger et al 2007; Sundquist et al 2005), and the biological mechanisms behind these benefits are well understood (Bouchard et al 2012; Bull et al 2004)
We exploit the comprehensive assessment offered by the Global Physical Activity Questionnaire (GPAQ) questionnaire to analyze and compare the associations of PA with the number of contemporaneous physician visits, when physical activity is either considered with a measure which aggregates activity across domains or with a measure that differentiates between domains
In contrast, while no association can be detected with the aggregate measure either, domain-specific effects can be identified with the differentiated measure for leisure time physical activity (LTPA): High LTPA is positively associated with the number visits, but this effect is mitigated for women who are active during travel time
Summary
Physical activity (PA) has been proven to be an important factor in the prevention of numerous chronical diseases (Bull et al 2004; Maruti et al 2008; Meisinger et al 2007; Sundquist et al 2005), and the biological mechanisms behind these benefits are well understood (Bouchard et al 2012; Bull et al 2004). As with each prevented case of illness the associated use of health care resources is avoided, PA is seen as a key modifiable factor in the struggle against ever rising health care expenditures.
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