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Scandinavian Journal of Public Health
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Review Article: Cost-effectiveness of healthcare-based interventions aimed at improving physical activity

Lars A. Hagberg

Örebro County Council, Department of Public Health, Sweden, lars.hagberg{at}orebroll.se, Public Health and Clinical Medicine, UmeÅ University, Sweden

Lars Lindholm

Public Health and Clinical Medicine, UmeÅ University, Sweden

Aim: This article aims to review current knowledge concerning the cost-effectiveness of healthcare-based interventions aimed at improving physical activity. Method: A search was performed for economic evaluations containing the terms ``physical activity'', ``exercise'', or ``fitness''. Cost-effectiveness for the articles found was described based on a model for evaluating interventions intended to promote physical activity. Results: A total of 26 articles were found in the search. Nine of them concern a general population, 7 evaluated older people, and 10 studied disease-specific populations. A preventive perspective is most common, but some have a treatment perspective. Around 20 of the interventions studied were cost-effective according to their authors, but all analyses had some shortcomings in their evaluation methods. Conclusion: This review found many examples of cost-effective interventions. There is a lack of evidence for the cost-effectiveness of interventions aimed at those whose only risk factor for illness is a sedentary lifestyle. There is more evidence, although it is limited, for the cost-effectiveness of interventions aimed at high-risk groups or those who manifest poor health related to physical inactivity. Most of the evidence for cost-effectiveness is for older people and those with heart failure. Promotion of physical activity can be cost-effective with different methods and in different settings, but there remains a lack of evidence for specific methods in specific populations.

Key Words: Cost-benefit analysis • cost-effectiveness analysis • cost-utility analysis • exercise • fitness • health economics • healthcare • intervention • promotion

Scandinavian Journal of Public Health, Vol. 34, No. 6, 641-653 (2006)
DOI: 10.1080/14034940600627853
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