Abstract
BackgroundIn health care interventions aimed at increased physical activity, the individual’s time spent on exercise is a substantial input. Time costs should therefore be considered in cost-effectiveness analyses. The aim of this study was to estimate the cost of time spent on exercise among 333 primary health care patients with metabolic risk factors receiving physical activity on prescription.MethodsBased on a theoretical framework, a yardstick was constructed with experience of work (representing claim of salary as compensation) as the lower anchor-point, and experience of leisure activity forgone due to extended exercise time (no claim) as the higher anchor-point. Using this yardstick experience of exercise can be valued. Another yardstick was constructed with experience of cleaning at home in combination with willingness to pay for cleaning as the lowest anchor-point.ResultsThe estimated costs of exercise time were between 14 and 37% of net wages, with physical activity level being the most important factor in determining the cost. Among sedentary individuals, the time cost was 21–51% of net wages while among individuals performing regular exercise it was 2–10%. When estimating the cost of time spent on exercise in a cost-effectiveness analysis, experience of exercise, work, leisure activity forgone, and cleaning at home (or other household work that may be relevant to purchase) should be measured. The individual’s willingness to pay for cleaning at home and their net salary should also be measured.ConclusionsWhen using a single valuation of cost of time spent on exercise in health care interventions, for employed participants 15–30% of net salary should be used. Among unemployed individuals, lower cost estimation should be applied. Better precision in cost estimations can be achieved if participants are stratified by physical activity levels.Trial registration The study was conducted as a survey of existing clinical physical activity on prescription work, and was approved by the Regional Ethical Review Board in Gothenburg, Sweden (ref: 678-14)
Highlights
In health care interventions aimed at increased physical activity, the individual’s time spent on exercise is a substantial input
Aim The primary aim of this study was to estimate the cost of time spent on exercise among patients with metabolic risk factors receiving physical activity on prescription (PAP)
For those who rate experience of exercise just below leisure activity forgone, if full net salary is considered as the cost of time spent on exercise, there is likely to be an overestimation of the cost
Summary
In health care interventions aimed at increased physical activity, the individual’s time spent on exercise is a substantial input. Time costs should be considered in cost-effectiveness analyses. The aim of this study was to estimate the cost of time spent on exercise among 333 primary health care patients with metabolic risk factors receiving physical activity on prescription. Hagberg et al Cost Eff Resour Alloc (2020) 18:14 From this perspective, the individual’s time spent on exercise is a substantial input and should be considered in analyses. The use of exercise cost was described in a review of cost-effectiveness of PA interventions [6], and in later articles, such as cost-effectiveness of physical activity on prescription (PAP) in a Swedish context [7, 8]. We have previously suggested a theoretical framework and a measurement method [10]; the framework is summarized below
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