Department of Medical Sociology and Health Economics, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany.
Eur J Health Econ. 2011 Aug;12(4):345-52. doi: 10.1007/s10198-010-0242-6. Epub 2010 Apr 18.
This study aimed to estimate the health burden and the direct as well as indirect costs of morbidity and mortality attributable to obesity and overweight in Germany for the year 2002. We used the concept of attributable fractions based on German prevalence data and relative risks from US studies as well as routine statistics. We estimated obesity- and overweight-attributable deaths, years of potential life lost (YPLL) and quality-adjusted life years lost (QALY) for various diseases associated with obesity and overweight. Direct costs were estimated for inpatient and outpatient treatment, rehabilitation and non-medical costs. Indirect costs were estimated for sickness absence, early retirement and mortality using the human capital approach. We estimated 36,653 obesity- and overweight-attributable deaths with 428,093 consecutive YPLL and 367,772 QALYs lost. Obesity caused 4,854 million EUR in direct costs corresponding to 2.1% of the overall German health expenditures in 2002 and 5,019 million EUR in indirect costs. Forty-three percent of direct costs resulted from endocrinological diseases like diabetes and obesity itself, followed by cardiovascular diseases (38%), neoplasms (14%) and digestive diseases (6%). Sixty percent of indirect costs resulted from unpaid work, and 67% of overall indirect costs were due to mortality. Obesity and overweight are connected to considerable morbidity and mortality as well as societal costs. Improvement and further development of effective strategies for preventing and dealing with obesity and overweight are necessary.
本研究旨在估计肥胖和超重导致的疾病负担以及发病率和死亡率的直接和间接成本，这些疾病负担和死亡率归因于德国 2002 年的肥胖和超重。我们使用了归因分数的概念，该概念基于德国的流行数据和美国研究的相对风险以及常规统计数据。我们估计了与肥胖和超重相关的各种疾病的肥胖和超重归因死亡、潜在寿命损失年数（YPLL）和质量调整生命年损失（QALY）。直接成本是根据住院和门诊治疗、康复和非医疗费用进行估算的。间接成本是根据人力资本方法，通过病假、提前退休和死亡率进行估算的。我们估计有 36653 例肥胖和超重归因死亡，随之而来的是 428093 个连续的 YPLL 和 367772 个 QALY 损失。肥胖导致 48.54 亿欧元的直接成本，相当于 2002 年德国总卫生支出的 2.1%，以及 50.19 亿欧元的间接成本。直接成本的 43%来自于糖尿病等内分泌疾病和肥胖本身，其次是心血管疾病（38%）、肿瘤（14%）和消化系统疾病（6%）。60%的间接成本来自于无报酬工作，而总间接成本的 67%归因于死亡率。肥胖和超重与相当大的发病率和死亡率以及社会成本有关。需要改进和进一步发展有效的预防和应对肥胖和超重的策略。
