Abstract
Background
Ageing populations are increasing demand for healthcare services, contributing to growing pressure on healthcare systems and rising expenditure. While physical activity (PA) is well established in preventing chronic conditions, its direct association with healthcare use in the general population remains less explored. This systematic review assesses the association between physical activity and healthcare use in the general population and whether socioeconomic position modifies this.
Methods
Medline, Embase, and CINAHL were searched from inception to August 18, 2025. Observational prospective studies examining physical activity and healthcare use in the general population were included. Risk of bias was assessed using an adapted Newcastle-Ottawa Scale. Data were synthesised narratively and by meta-analysis where appropriate. The certainty of evidence will be rated using the Grading of Recommendations Assessment, Development and Evaluation framework. Registered at PROSPERO: CRD420251117561.
Preliminary results
From 9,715 identified studies, 36 prospective studies were included, comprising 1644850 unique participants. Participants were aged 12–79 years, and 58% were female. Overall, bias was rated as moderate. Higher PA was associated with a trend towards lower medication use (odds ratio (OR) 0.72 95% CI 0.51–1.02; hazard ratio (HR) 0.80 95% CI 0.67–0.96) and lower hospitalisations (OR 0.75 95% CI 0.61–0.92; incidence rate ratio 0.78 95% CI 0.66–0.92; HR 0.83, 95% CI 0.69–1.00). General practitioner, specialist (OR 0.96 95% CI 0.79 to 1.18), emergency department, and mixed healthcare use showed inconsistent findings. Effect modification was observed in one of five studies.
Conclusions
Higher physical activity shows potential reductions in medication use and hospitalisations, but no consistent association was observed for other healthcare use outcomes. Overall, studies were limited by bias, and there was limited evidence of socioeconomic effect modification.
Key messages
• Higher physical activity is associated with reduced hospitalisations and shows a trend towards lower medication use, but no consistent association with other healthcare utilisation outcomes.
• The extent to which socioeconomic position modifies the relationship between physical activity and healthcare use appears minimal.