Health Economics Research Group, Division of Global Public Health, Department of Health Sciences, Brunel University London, UB8 3PH, UK.
Ministry of Health, Nutrition, Indegenous Medicine, Colombo 10, Sri Lanka.
BMJ Open. 2021 Jan 15;11(1):e037784. doi: 10.1136/bmjopen-2020-037784.
Promotion of physical activity (PA) among populations is a global health investment. However, evidence on economic aspects of PA is sparse and scattered in low-income and middle-income countries (LMICs).
The objective of this study was to summarise the available evidence on economics of PA in LMICs, identify potential target variables for policy and report gaps in the existing economic evidence alongside research recommendations.
A systematic review of the electronic databases (Scopus, Web of Science and SPORTDiscus) and grey literature.
Cost-of-illness studies, economic evaluations, interventions and descriptive studies on economic factors associated with PA using preset eligibility criteria.
Screening, study selection and quality appraisal based on standard checklists performed by two reviewers with consensus of a third reviewer. Descriptive synthesis of data was performed.
The majority of the studies were from upper-middle-income countries (n=16, 88.8%) and mainly from Brazil (n=9, 50%). Only one economic evaluation study was found. The focus of the reviewed literature spanned the economic burden of physical inactivity (n=4, 22%), relationship between PA and costs (n=6, 46%) and socioeconomic determinants of PA (n=7, 39%). The findings showed a considerable economic burden due to insufficient PA, with LMICs accounting for 75% of disability-adjusted life years (DALYs) globally due to insufficient PA. Socioeconomic correlates of PA were identified, and inverse relationship of PA with the cost of chronic diseases was established. Regular PA along with drug treatment as a treatment scheme for chronic diseases showed advantages with a cost-utility ratio of US$3.21/quality-adjusted life year (QALY) compared with the drug treatment-only group (US$3.92/QALY) by the only economic evaluation conducted in the LMIC, Brazil.
Meta-analysis was not performed due to heterogeneity of the studies.
Economic evaluation studies for PA promotion interventions/strategies and local research from low-income countries are grossly inadequate. Setting economic research agenda in LMICs ought to be prioritised in those areas.
CRD42018099856.
在全球范围内，促进人群的身体活动（PA）是一项健康投资。然而，有关 PA 的经济方面的证据在低收入和中等收入国家（LMICs）中仍然稀缺且分散。
本研究旨在总结 LMICs 中 PA 的经济学证据，确定政策的潜在目标变量，并报告现有经济证据中的空白以及研究建议。
对电子数据库（Scopus、Web of Science 和 SPORTDiscus）和灰色文献进行了系统综述。
使用预设的入选标准，对与 PA 相关的疾病成本研究、经济评估、干预措施和经济因素描述性研究进行了筛选。
两名评审员根据标准清单进行筛选、研究选择和质量评估，并由第三名评审员达成共识。对数据进行了描述性综合。
大多数研究来自中上收入国家（n=16，88.8%），主要来自巴西（n=9，50%）。仅发现一项经济评估研究。综述文献的重点涵盖了身体活动不足的经济负担（n=4，22%）、PA 与成本之间的关系（n=6，46%）和 PA 的社会经济决定因素（n=7，39%）。研究结果表明，由于缺乏身体活动，造成了相当大的经济负担，全球 75%的残疾调整生命年（DALYs）归因于身体活动不足。确定了 PA 的社会经济相关因素，并确立了 PA 与慢性病成本之间的反比关系。在唯一进行的经济评估中，巴西的一项经济评估表明，与仅药物治疗组（US$3.92/QALY）相比，经常进行 PA 以及将药物治疗作为慢性病治疗方案具有优势，其成本效用比为 US$3.21/QALY。
由于研究的异质性，未进行荟萃分析。
针对 PA 促进干预措施/策略的经济评估研究以及来自低收入国家的本地研究严重不足。应优先在这些地区制定 LMICs 的经济研究议程。
PROSPERO 注册号：CRD42018099856。
