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Association Between Preschool Physical Activity and Health Care Use and Burden in Children With Congenital Heart
Chang Sin Kim1, Minkyung Han2, Dong Hoon Lee3,4
1Division of Pediatric Cardiology, Department of Pediatrics, Severance Cardiovascular Hospital Yonsei University College of Medicine Seoul Republic of Korea.
Insights
Physical activity in preschool children with congenital heart disease (CHD) is linked to fewer hospitalizations and healthcare visits. Promoting early, tailored physical activity can reduce healthcare burden for these children.
Area of Science:
- Pediatrics
- Cardiology
- Public Health
Background:
- Physical activity is crucial for cardiovascular risk reduction in children with congenital heart disease (CHD).
- Limited evidence exists on this association in early childhood.
- This study investigates physical activity's impact on healthcare use in preschool-aged children with CHD.
Purpose of the Study:
- To examine the association between physical activity and healthcare utilization in preschool-aged children diagnosed with CHD.
- To assess the relationship between physical activity levels and healthcare burden, including hospitalizations and medical costs.
Main Methods:
- A nationwide cohort of 44,349 children born between 2014-2016 with CHD was analyzed using Korean National Health Insurance Service data.
- Children were classified as physically active or inactive based on a national infant health screening questionnaire.
- Health care use (hospitalizations, ICU days, tertiary/ED visits, costs) was assessed over 3 years, with adjustments for CHD severity and surgical complexity using weighting methods.
Main Results:
- Physical inactivity was significantly associated with increased risk of hospitalization, more tertiary outpatient visits, and longer intensive care unit (ICU) stays.
- No overall association was found with emergency department visits or total medical costs in the entire cohort.
- Significant effect modification by CHD severity was observed, with increased risks primarily in children with moderate-to-severe CHD.
Conclusions:
- Active participation in physical activities during preschool years is linked to reduced healthcare utilization in children with CHD.
- These findings support the development of early, individualized physical activity guidelines for children with CHD.
- Promoting physical activity may help mitigate healthcare burden in this vulnerable population.
Background:
Physical activity is essential for reducing cardiovascular risk in children with congenital heart disease (CHD). However, evidence of this association in early childhood remains limited. This study aimed to examine the association between physical activity and health care use and burden in preschool-aged children with CHD using a nationwide, population-based cohort in Korea.
Methods:
We analyzed data from 44 349 children born between 2014 and 2016 who were diagnosed with CHD and enrolled in the National Health Insurance Service database. Participants were categorized as physically active or inactive based on their responses to a national infant health screening questionnaire. Health care use, including hospitalizations, intensive care unit days, tertiary hospital and emergency department visits, and total medical costs, was assessed over a 3-year follow-up period. Adjustments were made for CHD severity and surgical complexity using American Heart Association and Risk Adjustment for Congenital Heart Surgery-2. Stabilized inverse probability of treatment weighting was applied to ensure robustness.
Results:
Physical inactivity was significantly associated with a higher risk of hospitalization, increased tertiary outpatient visits, and longer intensive care unit stays. Although no overall association was observed with emergency department visits or total medical costs in the overall cohort, significant effect modification by CHD severity was identified. These increased risks were specifically observed in children with moderate-to-severe CHD.
Conclusions:
Active participation in physical activities during preschool years was associated with reduced health care use among children with CHD, supporting the need for early, individualized physical activity guidelines.
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