Ludwig-Maximilians-Universität München, Munich School of Management, Institute of Health Economics and Health Care Management and Munich Centre of Health Sciences, Ludwigstr. 28 RG, 80539 Munich, Germany.
Eur J Health Econ. 2012 Feb;13(1):39-50. doi: 10.1007/s10198-010-0278-7. Epub 2010 Sep 29.
Childhood obesity is a growing public health burden. Among German children and adolescents, 15% are overweight (including obese) and 6.3% are obese according to a national reference. This is the first German study to assess aspects of the economic burden associated with overweight and obesity in children and adolescents based on a representative cross-sectional survey.
Based on the German Interview and Examination Survey for Children and Adolescents (KiGGS), direct costs induced by utilisation of healthcare services (physician and therapist visits, hospital stays) were assessed using a bottom-up approach. To investigate the impact of body mass index (BMI) on costs, univariate analyses were performed and multivariate generalised mixed models were estimated.
Average annual total costs were estimated to be €442 (95% CI [402-486]). Bivariate analysis showed considerable differences between BMI groups in physician costs, but not for hospital or therapist costs. High socioeconomic status, residence in west Germany and underweight had a significant negative impact on total costs in multivariate analysis. The effect of overweight on total costs is positive but not significant; neither is the effect of obesity. However, overweight and obese children exhibit significantly higher physician costs and a higher probability of being high utilisers of healthcare services.
The economic implications of overweight and obesity are, to some extent, already visible in childhood. The results suggest that obese children should be classified as priority group for prevention. Despite limitations, this study provides important information concerning the relevance of childhood obesity as a health problem.
儿童肥胖是一个日益严重的公共卫生负担。根据一项全国性参考数据，德国儿童和青少年中，15%超重（包括肥胖），6.3%肥胖。这是第一项基于代表性横断面调查评估德国儿童和青少年超重和肥胖相关经济负担的研究。
本研究基于德国儿童和青少年访谈和体检调查（KiGGS），采用自下而上的方法评估了利用医疗保健服务（医生和治疗师就诊、住院）产生的直接成本。为了研究体重指数（BMI）对成本的影响，进行了单变量分析，并估计了多变量广义混合模型。
估计平均年总成本为 442 欧元（95%置信区间[402-486]）。双变量分析显示，在医生费用方面，不同 BMI 组之间存在显著差异，但在医院或治疗师费用方面则没有差异。高社会经济地位、居住在西德和体重过轻对多变量分析中的总费用有显著的负向影响。超重对总费用的影响为正但不显著；肥胖也没有显著影响。然而，超重和肥胖儿童的医生费用显著较高，并且更有可能成为医疗服务的高使用者。
超重和肥胖的经济影响在一定程度上已经在儿童期显现出来。结果表明，肥胖儿童应被归类为预防的优先群体。尽管存在局限性，但本研究提供了有关儿童肥胖作为健康问题重要性的重要信息。
