Physical activity, deductibles and individual health expenditures.

Background: Adequate physical activity (PA) promotes health, but whether it also reduces health-related expenditures has not been thoroughly assessed. We investigated the association between PA levels and individual health expenditures and health insurance deductibles. Methods: Data from the third follow-up (2018-2021) of a prospective cohort study based in Lausanne, Switzerland. PA was measured via accelerometry and categorised as <or ≥150 min/week of moderate+vigorous PA (MVPA). Information on deductibles was self-reported. Health expenditures were obtained from health insurers. Results: Overall, 858 participants (53% females, 65.4±9.7 years) had deductible data. Participants with ≥150 min/week MVPA were more likely to choose higher health insurance deductibles than the less active group: 29.3% against 17.5%; p<0.001. However, this association was no longer significant after multivariable adjustment. Health expenditures were available for 360 participants (50.3 % females, 66.1±9.7 years). Participants with ≥150 min/week of MVPA had lower expenditures: median and (IQR) 1987 (427-5490) against 4118 (1699-8743) CHF, p<0.001. After multivariable adjustment, a nonsignificant (p=0.073) trend remained. Age, female sex and low deductible choice remained significant predictors of higher expenditures. In sex-stratified analyses, a significant inverse association was found between expenditures and MVPA: β (95% CI) -0.0034 (-0.0065 to -0.0003) in females, but not in males. Conclusions: Although less active individuals tend to choose lower deductibles, the association is mainly driven by clinical and sociodemographic factors. In women, each extra 30 min of MVPA per week was correlated to a 10% annual decrease in individual health expenditures, with a same borderline effect in the full sample.