Internal Medicine Department, State University of Rio de Janeiro (UERJ) and National Institute of Science and Technology for Health Technology Assessment (IATS) - CNPq/Brazil, Blv, 28 de Setembro 77, Rio de Janeiro/RJ, Brazil.
BMC Public Health. 2012 Jun 18;12:440. doi: 10.1186/1471-2458-12-440.
Obesity is a major global epidemic and a burden to society and health systems. It is well known risk factor for a number of chronic medical conditions with high morbidity and mortality. This study aimed to provide an estimate of the direct costs associated to outpatient and inpatient care of overweight and obesity related diseases in the perspective of the Brazilian Health System (SUS).
Population attributable risk (PAR) was calculated for selected diseases related to overweight and obesity and with the following parameters: Relative risk (RR) ≥ 1.20 or RR ≥ 1.10 and < 1.20, but important problem of public health due its high prevalence. After a broad search in the literature, two meta-analysis were selected to provide RR for PAR calculation. The prevalence rates of overweight and obesity in Brazilians with ≥ 18 years were obtained from large national survey. The national health database (DATASUS) was used to estimate the annual cost of the Brazilian Unified Health System (SUS) with the diseases included in the analysis. The extracted values were stratified by sex, type of service (inpatient or outpatient care) and year. Data were collected from 2008 to 2010 and the results reflect the average of 3 years. Brazilian costs were converted into US dollars during the analysis using a purchasing power parity basis (2010).
The estimated total costs in one year with all diseases related to overweight and obesity are US$ 2,1 billion; US$ 1,4 billion (68.4% of total costs) due to hospitalizations and US$ 679 million due to ambulatory procedures. Approximately 10% of these cost is attributable to overweight and obesity.
The results confirm that overweight and obesity carry a great economic burden for Brazilian health system and for the society. The knowledge of these costs will be useful for future economic analysis of preventive and treatment interventions.
肥胖是一个全球性的主要流行疾病，给社会和卫生系统带来了沉重负担。它是多种慢性疾病的重要危险因素，这些疾病具有较高的发病率和死亡率。本研究旨在从巴西卫生系统（SUS）的角度，对与超重和肥胖相关的疾病门诊和住院治疗的直接费用进行估计。
针对与超重和肥胖相关的某些疾病，计算了人群归因风险（PAR），并使用以下参数：相对风险（RR）≥1.20 或 RR≥1.10 且<1.20，但由于其高患病率，属于重要的公共卫生问题。在文献中进行了广泛搜索后，选择了两项荟萃分析来提供 PAR 计算的 RR。从大型全国性调查中获得了巴西≥18 岁人群中超重和肥胖的患病率。利用国家卫生数据库（DATASUS）来估计巴西统一卫生系统（SUS）每年因纳入分析的疾病而产生的费用。按性别、服务类型（住院或门诊治疗）和年份对提取的值进行分层。数据收集时间为 2008 年至 2010 年，结果反映了 3 年的平均值。在分析过程中，使用购买力平价（2010 年）将巴西成本转换为美元。
一年中与所有超重和肥胖相关疾病相关的总成本为 21 亿美元；其中 14 亿美元（总费用的 68.4%）归因于住院治疗，6.79 亿美元归因于门诊治疗。这些费用中约有 10%归因于超重和肥胖。
研究结果证实超重和肥胖给巴西卫生系统和社会带来了巨大的经济负担。了解这些费用将有助于未来对预防和治疗干预措施进行经济分析。
