Healthcare Costs and Utilization Associated with Participation in the National Fitness Award Program: Analysis using Linked NHIS Data

PURPOSE: This study examined the influence of participation in the National Fitness Award (NFA) program on healthcare costs and utilization by analyzing linked data from the NFA database and the National Health Insurance Service (NHIS).METHODS: A total of 721 individuals who participated in the NFA program between 2013 and 2017 and consented to data linkage were included in the study. A control group comprising 1,426 individuals was selected from the NHIS big data through 1:2 propensity score matching based on age, sex, and healthcare utilization in the year before the index date. This study was conducted as part of an official NHIS research project. Changes in healthcare utilization and costs before and after NFA participation were analyzed and compared with the control group to assess the effectiveness of the program.RESULTS: From the year before the intervention to the year following NFA participation, total healthcare costs increased by approximately 70,000 KRW in the participating group and by approximately 470,000 KRW in the control group. After adjusting covariates and applying the difference-in-differences (DiD) methodology, the NFA participants demonstrated the following reductions relative to the control group: 0.1 fewer total number of inpatient visits, approximately 402,000 KRW lower total healthcare costs, 1.9 fewer inpatient visit days, 2.4 fewer inpatient treatment days, and a reduction of approximately 339,000 KRW in inpatient healthcare costs.CONCLUSIONS: The findings suggest that participation in the NFA program was associated with reductions in overall healthcare costs and utilization. These results highlight the effectiveness of fitness programs as a cost-efficient strategy for managing rising healthcare costs.