Burden of physical inactivity and hospitalization costs due to chronic diseases

OBJECTIVE To evaluate the physical inactivity-related inpatient costs of chronic non-communicable diseases. METHODS This study used data from 2013, from Brazilian Unified Health System, regarding inpatient numbers and costs due to malignant colon and breast neoplasms, cerebrovascular diseases, ischemic heart diseases, hypertension, diabetes, and osteoporosis. In order to calculate the share physical inactivity represents in that, the physical inactivity-related risks, which apply to each disease, were considered, and physical inactivity prevalence during leisure activities was obtained from Pesquisa Nacional por Amostra de Domicílio (Brazil's National Household Sample Survey). The analysis was stratified by genders and residing country regions of subjects who were 40 years or older. The physical inactivity-related hospitalization cost regarding each cause was multiplied by the respective share it regarded to. RESULTS In 2013, 974,641 patients were admitted due to seven different causes in Brazil, which represented a high cost. South region was found to have the highest patient admission rate in most studied causes. The highest prevalences for physical inactivity were observed in North and Northeast regions. The highest inactivity-related share in men was found for osteoporosis in all regions (≈ 35.0%), whereas diabetes was found to have a higher share regarding inactivity in women (33.0% to 37.0% variation in the regions). Ischemic heart diseases accounted for the highest total costs that could be linked to physical inactivity in all regions and for both genders, being followed by cerebrovascular diseases. Approximately 15.0% of inpatient costs from Brazilian Unified Health System were connected to physical inactivity. CONCLUSIONS Physical inactivity significantly impacts the number of patient admissions due to the evaluated causes and through their resulting costs, with different genders and country regions representing different shares.研究目的：评估与体力活动不足相关的慢性非传染性疾病住院费用。 研究方法：本研究采用2013年巴西统一健康系统（Brazilian Unified Health System）的相关数据，涵盖结直肠恶性肿瘤、乳腺恶性肿瘤、脑血管疾病、缺血性心脏病、高血压、糖尿病及骨质疏松症的住院人次与住院成本。为测算体力活动不足在上述住院成本中所占的归因比例，本研究纳入各疾病对应的体力活动不足相关风险，并利用巴西全国住户抽样调查（Pesquisa Nacional por Amostra de Domicílio，National Household Sample Survey）获取闲暇时间体力活动不足的患病率。分析按40岁及以上受试者的性别与巴西国内居住地区进行分层。将各病因下与体力活动不足相关的住院成本乘以其对应的归因占比，最终得到相关成本的贡献比例。 研究结果：2013年，巴西因上述7类病因住院的患者共计974641人次，产生了高额住院费用。在多数研究纳入的病因中，南部地区的患者住院率最高。体力活动不足患病率最高的地区为北部与东北部地区。男性群体中，各地区与体力活动不足相关的归因占比最高的疾病均为骨质疏松症（约35.0%）；而女性群体中，糖尿病的体力活动不足归因占比最高，各地区区间为33.0%~37.0%。在所有地区及两性群体中，缺血性心脏病的体力活动不足相关总住院成本最高，其次为脑血管疾病。巴西统一健康系统约15.0%的住院费用与体力活动不足相关。 研究结论：体力活动不足对本次评估的各类病因的住院人次及相关成本均产生显著影响，且不同性别与国内地区的归因占比存在差异。