Zhao W, Zhai Y, Hu J, Wang J, Yang Z, Kong L, Chen C
Chinese Centre for Diseases Control and Prevention, Beijing, China.
Obes Rev. 2008 Mar;9 Suppl 1:62-7. doi: 10.1111/j.1467-789X.2007.00440.x.
The objectives of the present study are: (i) to estimate annual direct medical costs of chronic diseases attributable to overweight and obesity among adults in China and (ii) to predict the medical costs if the epidemic continues developing. Using 2002 National Nutrition and Health Survey (n = 39,834), the prevalence of overweight [24 > or = body mass index (BMI) < 28] and obesity (BMI > or = 28), and population attributable risks (PARs) for hypertension, type 2 diabetes, coronary heart disease and stroke were calculated. The 2003 third National Health Services Survey (n = 143,521) was used to derive direct medical costs including costs for outpatient visits, physician services, inpatient stays, rehabilitation services, nursing fees and medications. The medical costs attributable to overweight and obesity were estimated by multiplying the disease costs by PAR for each disease. The total medical cost attributable to overweight and obesity was estimated at 21.11 billion Yuan (RMB) (approximately $2.74 billion) accounting for 25.5% of the total medical costs for the four chronic diseases, or 3.7% of national total medical costs in 2003. The medical cost associated with overweight and obesity could increase to 37 billion Yuan (RMB) (approximately $4.8 billion), a 75% increase, if the epidemic developed speedily and the ratio of overweight to obesity approached 1.1:1. The high economic burden of overweight and obesity suggests an urgent need to develop effective interventions for controlling the obesity epidemic and consequently the prevention of chronic diseases.
（i）估算中国成年人中归因于超重和肥胖的慢性病年度直接医疗费用，以及（ii）预测如果该流行趋势持续发展的医疗费用。利用2002年全国营养与健康调查（n = 39834），计算超重[体重指数（BMI）≥24且<28]和肥胖（BMI≥28）的患病率，以及高血压、2型糖尿病、冠心病和中风的人群归因风险（PARs）。使用2003年第三次全国卫生服务调查（n = 143521）得出直接医疗费用，包括门诊就诊、医生服务、住院、康复服务、护理费和药物费用。通过将每种疾病的费用乘以PAR来估算归因于超重和肥胖的医疗费用。归因于超重和肥胖的总医疗费用估计为211.1亿元人民币（约27.4亿美元），占四种慢性病总医疗费用的25.5%，或2003年全国总医疗费用的3.7%。如果该流行趋势迅速发展且超重与肥胖的比例接近1.1:1，与超重和肥胖相关的医疗费用可能增至370亿元人民币（约48亿美元），增长75%。超重和肥胖带来的高经济负担表明迫切需要制定有效的干预措施来控制肥胖流行并进而预防慢性病。
