Allison D B, Zannolli R, Narayan K M
Obesity Research Center, St. Luke's/Roosevelt Hospital, Columbia University College of Physicians and Surgeons, New York, NY 10025, USA.
Am J Public Health. 1999 Aug;89(8):1194-9. doi: 10.2105/ajph.89.8.1194.
Recent estimates suggest that obesity accounts for 5.7% of US total direct health care costs, but these estimates have not accounted for the increased death rate among obese people. This article examines whether the estimated direct health care costs attributable to obesity are offset by the increased mortality rate among obese individuals.
Data on death rates, relative risks of death with obesity, and health care costs at different ages were used to estimate direct health care costs of obesity from 20 to 85 years of age with and without accounting for increased death rates associated with obesity. Sensitivity analyses used different values of relative risk of death, given obesity, and allowed the relative costs due to obesity per unit of time to vary with age.
Direct health care costs from 20 to 85 years of age were estimated to be approximately 25% lower when differential mortality was taken into account. Sensitivity analyses suggested that direct health care costs of obesity are unlikely to exceed 4.32% or to be lower than 0.89%.
Increased mortality among obese people should be accounted for in order not to overestimate health care costs.
近期估计表明,肥胖占美国直接医疗保健总费用的5.7%,但这些估计未考虑肥胖人群死亡率的上升。本文探讨肥胖导致的估计直接医疗保健费用是否被肥胖个体死亡率的上升所抵消。
利用不同年龄的死亡率、肥胖相关死亡相对风险和医疗保健费用数据,在考虑和不考虑肥胖相关死亡率上升的情况下,估算20至85岁肥胖人群的直接医疗保健费用。敏感性分析采用不同的肥胖相关死亡相对风险值,并允许肥胖导致的单位时间相对费用随年龄变化。
考虑到差异死亡率时,20至85岁的直接医疗保健费用估计降低约25%。敏感性分析表明,肥胖的直接医疗保健费用不太可能超过4.32%,也不太可能低于0.89%。
为避免高估医疗保健费用,应考虑肥胖人群死亡率的上升。