Fu T, Wen T, Yeh P, Chang H
Institute of Economics, Academia Sinica, Taipei, Taiwan.
Obes Rev. 2008 Mar;9 Suppl 1:68-73. doi: 10.1111/j.1467-789X.2007.00441.x.
The objective of this paper is to estimate the cost of obesity's contribution to the metabolic syndrome diseases in Taiwan. We used individual data from the Cardiovascular Disease Risk Factors Two-Township Study survey and medical use and expenditures data from the Bureau of National Health Insurance (NHI) of Taiwan. By adopting the prevalence-based and population attributable risk (PAR) approaches, direct costs of obesity for six kinds of obesity related metabolic syndrome diseases have been estimated. Comorbidities used in our analysis included ischemic heart diseases, congestive heart failure, cerebrovascular disease accident, diabetes, hyper-cholesterolaemia and hypertension. The results indicate that overweight and obesity are associated with a higher prevalence and costs of the metabolic syndrome related diseases. PAR increases as the obese [body mass index (BMI)] prevalence increases. About 4-9% of the costs of those diseases can be attributed to overweight (24 < or = BMI < 27) and about 7-13% and 8-19% of such costs are attributable to the first and second degree obesity (27 < or = BMI < 30 and BMI > or = 30). The cost of obesity derived from the PAR and medical costs of metabolic syndrome diseases accounts for 2.9% of the national total healthcare expenditure. We therefore conclude that overweight and obesity have increased health costs and resulted in higher prevalence of and greater costs from metabolic syndrome related diseases in Taiwan. These findings provide important support for implementing obesity prevention programs in Taiwan.
本文的目的是估算肥胖对台湾代谢综合征疾病造成的成本。我们使用了心血管疾病风险因素双乡镇研究调查中的个体数据,以及台湾国民健康保险局(NHI)的医疗使用和支出数据。通过采用基于患病率和人群归因风险(PAR)的方法,估算了六种与肥胖相关的代谢综合征疾病的肥胖直接成本。我们分析中使用的合并症包括缺血性心脏病、充血性心力衰竭、脑血管意外、糖尿病、高胆固醇血症和高血压。结果表明,超重和肥胖与代谢综合征相关疾病的较高患病率和成本相关。PAR随着肥胖[体重指数(BMI)]患病率的增加而增加。这些疾病约4 - 9%的成本可归因于超重(24≤BMI<27),约7 - 13%和8 - 19%的此类成本分别归因于一度和二度肥胖(27≤BMI<30和BMI≥30)。由PAR得出的肥胖成本以及代谢综合征疾病的医疗成本占国家医疗总支出的2.9%。因此,我们得出结论,超重和肥胖增加了台湾的医疗成本,并导致代谢综合征相关疾病的患病率更高、成本更高。这些发现为台湾实施肥胖预防计划提供了重要支持。