Inputs and Outcomes of Physical Activity: A Health Economic Perspective

Sören Dallmeyer

Inputs and Outcomes of Physical Activity: A Health Economic Perspective

Titel in Übersetzung: Inputs und Outcomes von körperlicher Aktivität: Eine gesundheitsökonomische Perspektive

Sören Dallmeyer

Abteilung Sportmanagement

Publikation: Buch/Bericht › Dissertationsschrift

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Abstract

Öffentliche Investitionen zur Förderung von körperlicher Aktivität sind oftmals umstritten
und häufig Bestandteil von Budgetkürzungen öffentlicher Haushalte. Dies
ist insbesondere aus gesundheitsökonomischer Perspektive problematisch, da körperliche
Aktivität aufgrund der nachgewiesenen positiven Effekte auf die individuelle
Gesundheit ein geeignetes Instrument darstellt, um die Kosten für Gesundheitssysteme
zu reduzieren. Eine Berechnung des return on investment öffentlicher Investitionen
in körperliche Aktivität kann daher für politische Entscheidungsträger eine
wichtige Orientierung bei der Vergabe finanzieller Mittel darstellen.
Die vorliegende Dissertation entwickelt zunächst auf Basis bestehender Evaluationsmethoden
ein Health-Return on Investment Modell (HROI), das die Beziehung
zwischen dem Input (öffentliche Investitionen), dem Output (körperliche Aktivität)
und dem Outcome (Gesundheitskosten) beschreibt. Anschließend werden in den
Kapiteln vier bis sieben vier Studien dargestellt, die die empirische Evidenzlage zu
verschiedenen Zusammenhängen innerhalb des Modells erweitern.
Kapitel vier und fünf legen dabei den Fokus auf die Input-Output-Beziehung. In
Kapitel vier wird der Zusammenhang zwischen spezifisch auf Sport zielende öffentliche
Ausgaben und sportlicher Aktivität untersucht. Die Ergebnisse deuten
darauf hin, dass die Effekte häufig verzögert auftreten und insbesondere Investitionen
in Sportinfrastruktur einen positiven Einfluss auf die sportliche Aktivität
besitzen. Kapitel 5 zeigt, dass zusätzlich zu sport-spezifischen Investitionen auch
Ausgaben in anderen Bereichen Einfluss auf die Sportpartizipation haben können.
So können positive Effekte für öffentliche Investitionen in Transportinfrastruktur
nachgewiesen werden. Kapitel sechs und sieben beschäftigen sich mit der Output-
Outcome-Beziehung. In Kapitel sechs wird der Einfluss körperlicher Aktivität auf
Out-of-pocket-Gesundheitskosten von Senioren geschätzt. Die Ergebnisse verdeutlichen,
dass ältere Menschen ihre Gesundheitsausgaben signifikant durch körperliche
Aktivität verringern können. Kapitel sieben analysiert den Einfluss von körperlicher
Aktivität auf Gesundheitskosten aus einer Makroperspektive. Durch Anwendung
der komparativen Risikomethode wird die Entwicklung der Kosten körperlicher Inaktivität
in Deutschland für die Jahre 2001-2013 geschätzt. Zusätzlich zeigt die
Studie, dass die Kosten körperlicher Inaktivität aufgrund einer immer älter werdenden
Bevölkerung erheblich steigen könnten.
Insgesamt stellt die Dissertation einen ersten Beitrag zur Messung des HROI von
körperlicher Aktivität dar. Der bestehende Forschungsstand zur Input-Output- und
Output-Outcome-Beziehung innerhalb des Modells wird erweitert und dabei insbesondere
um das Element des demographischen Wandels ergänzt.

Titel in Übersetzung	Inputs und Outcomes von körperlicher Aktivität: Eine gesundheitsökonomische Perspektive
Originalsprache	Englisch

Erscheinungsort	Köln
Verlag	Deutsche Sporthochschule Köln
Seitenumfang	49
Publikationsstatus	Veröffentlicht - 03.06.2020

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Zitation

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title = "Inputs and Outcomes of Physical Activity: A Health Economic Perspective",

abstract = "Public investments in physical activity, particularly in times of fiscal austerity, areregular targets governmental budget cuts. From a health economic perspective,this is especially problematic as physical activity, for all its well-documented health benefits, actually represents an appropriate mechanism to reduce the increasing costs of public health systems. An estimation of a return on investment of public spending on physical activity thus may serve as a useful point of reference for policy makers when allocating financial resources.Drawing on existing economic evaluation methods, the present thesis develops ahealth return on investment (HROI) framework, describing the relationship between input (public investments), output (physical activity), and outcome (health costs). Moreover, in sections four to seven, four academic papers are presented, providing new empirical evidence to the different relationships of such HROI framework. In sections four and five, the focus is on the input-output relationship. Section four takes a look at the effect of sport-related public investments on sport participation. The results indicate that the effects are most likely lagged and that, in particular, investments in sports infrastructure do positively affect sports participation. Section five demonstrates that, in addition to sport-related spending, public investments in other areas have to be considered. For example, a positive relationship between transport infrastructure and sports participation can be demonstrated. Section six and seven then concentrate on the output-outcome relationship. Section six investigates the effect of physical activity on out-of-pocket health costs of the elderly. The results show that older people can in fact significantly reduce their health costs by becoming physically active. Section seven analyzes the effect of physical activity on health costs from a macro-perspective. Applying the comparative risk method allows to estimate the costs of inactivity for the period 2001-2013.Moreover, the study reveals that demographic changes are likely to increase thecosts of physical inactivity. Overall the thesis represents a first step in measuring the HROI of public investment in physical activity. It adds to the existing empirical evidence on two of the core relationships of the HROI framework by specifically considering the transformative context of an aging society.",

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Inputs and Outcomes of Physical Activity: A Health Economic Perspective

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