Abstract
BackgroundWhile physical activity interventions have been reported to reduce hospital stays, it is not clear if, in the general population, usual physical activity patterns may be associated with subsequent hospital use independently of other lifestyle factors.ObjectiveWe examined the relationship between reported usual physical activity and subsequent admissions to hospital and time spent in hospital for 11,228 men and 13,786 women aged 40–79 years in the general population.MethodsParticipants from a British prospective population-based cohort study were followed for 20 years (1999–2019) using record linkage to document hospital usage. Total physical activity was estimated by combining workplace and leisure time activity reported in a baseline lifestyle questionnaire and repeated in a subset at a second time point approximately 12 years later.ResultsCompared to those reporting no physical activity, participants who were the most active had a lower likelihood of spending more than 20 days in hospital odds ratio (OR) 0.88 (95% confidence interval (CI) 0.81–0.96) over the next 20 years after multivariable adjustment for age, sex, smoking status, education, social class and body mass index. Participants reporting any activity had a mean of 0.42 fewer hospital days per year between 1999 and 2009 compared to inactive participants, an estimated potential saving to the National Health Service (NHS) of £247 per person per year, or approximately 7% of UK health expenditure. Participants who remained physically active or became active 12 years later had lower risk of subsequent hospital usage than those who remained inactive or became inactive, p-trend < 0.001.ConclusionUsual physical activity in this middle-aged and older population predicts lower future hospitalisations - time spent in hospital and number of admissions independently of behavioural and sociodemographic factors. Small feasible differences in usual physical activity in the general population may potentially have a substantial impact on hospital usage and costs.
Highlights
UK government spending on health has risen on average by 3.7% per year since 1948, outpacing economic growth over the period [1, 2]
This study examines the relationship between measures of physical activity using a validated physical activity scale, change in physical activity, and subsequent hospital usage, in older men and women living in the general community over a 10-year period, and a subsequent 10-year follow-up period, taking into account a range of demographic and lifestyle factors
The multivariable-adjusted models indicate that participants with a physical activity score of at least moderately inactive had fewer hospital admissions and fewer days in hospital, than those who were inactive
Summary
UK government spending on health has risen on average by 3.7% per year since 1948, outpacing economic growth over the period [1, 2]. There are many factors which may influence hospital usage, not all of which are related to ill health while increases in expenditure are only partly explained by demographic changes [4]. Changes in modifiable lifestyle factors have the potential to lower hospital length of stay. There is growing evidence of the effectiveness of preoperative exercise programmes and other pre-admission interventions in reducing hospital length of stay and readmission rates [5,6,7,8,9] but it is unclear whether in the general population, usual physical activity is related to hospital use. While physical activity interventions have been reported to reduce hospital stays, it is not clear if, in the general population, usual physical activity patterns may be associated with subsequent hospital use independently of other lifestyle factors
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