Exercise Dimensions and Medical Expenditure Among Persons with Disabilities in South Korea: The Role of Subjective Health

Background/Objectives: Exercise participation is multidimensional, but whether frequency, duration, and intensity show distinct associations with medical expenditure among persons with disabilities remains unclear. Methods: Using cross-sectional, nationally representative data from the 2024 National Survey on Sports Participation for Persons with Disabilities in South Korea (unweighted N = 10,000; weighted population estimate = 1,502,793 registered persons with disabilities aged 10–69 years), sampling-weighted structural equation modeling examined direct and statistical indirect associations of exercise dimensions with annual out-of-pocket medical expenditure through subjective health, adjusting for sex, age, household income, disability severity, walking ability, and disability type. Results: In the primary model, exercise frequency was significantly inversely associated with subjective health, whereas duration and intensity were positively associated; subjective health was inversely associated with medical expenditure. Frequency and duration showed significant positive direct associations with medical expenditure, whereas intensity showed no significant direct association. Sensitivity analyses qualified these findings: the inverse frequency-subjective health association was attenuated and non-significant among exercisers only, whereas the positive associations of duration and intensity with subjective health remained significant. A two-part expenditure analysis also showed that direct exercise–expenditure associations differed between expenditure occurrence and expenditure amount, while subjective health remained inversely associated with both components. Disability-type differences were also observed. Conclusions: These cross-sectional findings support analyzing exercise dimensions separately but do not establish causal mediation or justify clinical prioritization of any specific exercise dimension.