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Table 3 Cost results

From: The value of walking: a systematic review on mobility and healthcare costs

Publication

Walking outcomes

Utilization results

Direct Costs results (adjusted to 2021 USD)

Perkins et al. 2001 [21]

PRO: Walking Time (average minutes of walking per week by newly developed questionnaire)

Walking 120 or more minutes was associated with a lower risk of emergency room visit (OR = 0.5) and hospital stay (OR = 0.6) in the subsequent year

Total annual costs for those walking 0 min per week (8,123 $) vs. those walking more than 120 min per week (2,844 $)

Inpatient costs for those walking 0 min per week (6,018 $) vs. those walking more than 120 min per week (1,814 $)

Emergency room for those walking 0 min per week (1,109 $) vs. those walking more than 120 min per week (388 $)

Tsuji et al. 2003 [22]

PRO: Walking Time (self-reported walking duration per day (3 factor levels))

Compared with those walking >  = 1 h/day, per capita per month cost for inpatient care in those walking >  = 30 min was 16% higher. For outpatient care, both the number of visits and the medical cost also significantly increased with shorter walking time

Medical costs significantly reduced with longer time spent walking. Per capita medical cost was 173 $ per month in those who walked for 30 min/day, 168 $ in those who walked for 30 min–1 h, and 115 $ in those who walked for more than 1 h

Purser et al. 2005 [23]

PerfO: Walking Speed (timed 50 feet walking trial as part of the ‘Reuben’s Physical Performance Test’)

Each 0.10 m/s reduction in baseline walking speed was associated with additional rehabilitation visits (1.4 to 2.5), increased medical-surgical visits (1.9 to 3.7), and longer hospital stays (1.4 to 2.9)

Each 0.10 m/s/yr increase in walking speed resulted in fewer hospitalization days (2.3 [1.3 to 3.3])

Each 0.10 m/s reduction in baseline walking speed was associated with higher costs (1,854 $ [1,207 $ to 2,499 $])

Each 0.10 m/s/yr increase in walking speed resulted in 1-year cost reductions of 1,651 $ [–90 $ to 3,394 $]

Kato et al. 2013 [24]

No direct mobility measures (derived from literature) calculated steps

Not reported

In 10 years, the total medical costs were 5.2 and 8.4% lower for 3,000 and 5,000 steps increase, respectively. The cost reduction associated with a daily increase of 3,000 steps walked was calculated as 0,000,014 $ for each step

Turi et al. 2015 [25]

PRO: Activity of daily living (walking during leisure time as self-reported in retrospective questionnaire ‘Baecke Questionnaire’)

Not reported

Participants inserted in the category of higher involvement in walking were 41% less likely to be inserted into the group with higher total expenditure (r = 0.59; 95% CI 0.39–0.89)

Kabiri et al. 2018 [26]

Step Count

No direct mobility measure (derived from MARCHE trial)

The model predicted that a 554-step-per-day increase in mobility would reduce nursing home utilization by 2.8%

The model predicted an increase of 554-step per day increase would reduce total medical expenditures by 0.9%

Karl et al. 2018 [27]

DMO: Step Count (Self-reported hours of exercise per week. Accelerometer (worn during waking hours for 7 days) for uniaxial counts (counts/min) on the vertical axis for the deduction of activity levels and step counts)

Not reported

No significant results

(Inactive participants (less than 10,000 steps per day), had higher direct healthcare costs as compared to active subjects)

Bonnini et al. 2020 [28]

PerfO: Walking speed (maintained during a moderate 1-km treadmill-walking test)

Every 1 km/hour increase in walking speed was associated with a 21% reduction in risk of hospitalization (HR 0.79)

Hospitalization costs in the first, second and third propensity score tertile per patient were reduced from 1,281 to 341 $, from 904 to 383 $, and from 1,197 to 334 $ among low and high improvers in walking speed

Okayama et al. 2021 [29]

PerfO: Walking speed (distance covered by walking up and down a 10 m course at a different dictated velocities, termed “incremental shuttle walking distance” (ISWD))

The mobile group had shorter cumulative lengths of hospital stay (41.3 vs. 72.9 days/person) than the less mobile group

The mobile group had lower inpatient medical costs (16,680 $ vs. 25,458 $ /person) than the less mobile group

Hirai et al. 2021 [30]

PRO: Walking Time (categorized average minutes of walking per week by questionnaire)

Not reported

Cumulative LTCI costs were USD 3200 for those who walked for less than 30 min, USD 2400 for those who walked for 30 to 60 min, and USD 2100 for those who walked for more than 60 min

  1. Abbreviations: PRO patient reported outcome, PerfO performance outcome, DMO digital mobility outcome