Prevention Research Collaboration, Sydney School of Public Health, The University of Sydney, Camperdown, Australia.
Centre for Chronic Disease Prevention, College of Public Health, Medical and Veterinary Sciences, James Cook University, Cairns, Australia.
Br J Sports Med. 2017 Oct;51(19):1392-1409. doi: 10.1136/bjsports-2016-097385. Epub 2017 Apr 26.
To summarise the literature on the economic burden of physical inactivity in populations, with emphases on appraising the methodologies and providing recommendations for future studies.
Systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PROSPERO registration number CRD42016047705).
Electronic databases for peer-reviewed and grey literature were systematically searched, followed by reference searching and consultation with experts.
Studies that examined the economic consequences of physical inactivity in a population/population-based sample, with clearly stated methodologies and at least an abstract/summary written in English.
Of the 40 eligible studies, 27 focused on direct healthcare costs only, 13 also estimated indirect costs and one study additionally estimated household costs. For direct costs, 23 studies used a population attributable fraction (PAF) approach with estimated healthcare costs attributable to physical inactivity ranging from 0.3% to 4.6% of national healthcare expenditure; 17 studies used an econometric approach, which tended to yield higher estimates than those using a PAF approach. For indirect costs, 10 studies used a human capital approach, two used a friction cost approach and one used a value of a statistical life approach. Overall, estimates varied substantially, even within the same country, depending on analytical approaches, time frame and other methodological considerations.
Estimating the economic burden of physical inactivity is an area of increasing importance that requires further development. There is a marked lack of consistency in methodological approaches and transparency of reporting. Future studies could benefit from cross-disciplinary collaborations involving economists and physical activity experts, taking a societal perspective and following best practices in conducting and reporting analysis, including accounting for potential confounding, reverse causality and comorbidity, applying discounting and sensitivity analysis, and reporting assumptions, limitations and justifications for approaches taken. We have adapted the Consolidated Health Economic Evaluation Reporting Standards checklist as a guide for future estimates of the economic burden of physical inactivity and other risk factors.
总结人群体力活动不足的经济负担相关文献，重点评估方法并为未来研究提供建议。
遵循系统评价和荟萃分析报告标准（PROSPERO 注册编号 CRD42016047705）的系统综述。
系统检索同行评审和灰色文献电子数据库，随后进行参考文献检索和专家咨询。
研究考察了人群/基于人群的样本中体力活动不足的经济后果，方法明确，并至少有英文摘要/总结。
40 项符合条件的研究中，27 项仅关注直接医疗成本，13 项还估计了间接成本，1 项研究还额外估计了家庭成本。对于直接成本，23 项研究使用人群归因分数（PAF）方法，估计归因于体力活动不足的医疗保健费用占国家医疗保健支出的 0.3%至 4.6%；17 项研究使用计量经济学方法，其结果往往高于 PAF 方法。对于间接成本，10 项研究使用人力资本方法，2 项研究使用摩擦成本方法，1 项研究使用生命统计价值方法。总体而言，即使在同一国家内，由于分析方法、时间框架和其他方法考虑因素的不同，估计值也存在很大差异。
估计体力活动不足的经济负担是一个日益重要的领域，需要进一步发展。在方法学方法和报告的透明度方面存在明显的不一致。未来的研究可以从涉及经济学家和体力活动专家的跨学科合作中受益，从社会角度出发，并遵循进行和报告分析的最佳实践，包括考虑潜在的混杂因素、反向因果关系和共病，应用贴现和敏感性分析，并报告所采用方法的假设、局限性和理由。我们根据合并健康经济评估报告标准清单进行了改编，作为未来体力活动不足和其他风险因素经济负担估计的指南。
