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Introduction As the global population continues to age, the physical and mental health of middle-aged and older adults, along with their medical expenditures, has increasingly drawn societal attention. This study examines the relationship between physical exercise among middle-aged and older adults and their medical expenditures, aiming to provide scientific evidence for improving their quality of life and reducing medical expenditures. Methods On the basis of data from the 2020 to 2022 China Family Panel Studies (primarily self-reported or household member-reported data), this research uses baseline regression, mediating effects and moderating effects to explore the impact of physical exercise on medical expenditures among middle-aged and older adults. Results The results of this study revealed the following: (1) physical exercise significantly suppresses medical expenditures among middle-aged and older adults, a finding that remains robust after multiple sensitivity checks; (2) physical exercise reduces medical expenditures by promoting physical and mental health in this demographic group; (3) digital literacy enhances the inhibitory effect of physical exercise on medical expenditures, with digital professional literacy being the only dimension to exhibit a significant moderating effect; and (4) the moderating effect of digital literacy is significant among males, urban residents, and those with higher education levels but not among females, rural residents, or those with lower education levels. Discussion This study not only contributes to the systematic identification and scientific evaluation of the potential economic benefits of physical exercise within the framework of health economics, thereby providing a scientific foundation for the health management and medical expenditures of middle-aged and older adults but also expands the interdisciplinary research perspective at the intersection of health economics and digital governance, enriching the theoretical explanatory framework in these fields.
Hao et al. (Fri,) studied this question.