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英国前瞻性肥胖模型在爱尔兰的应用:爱尔兰预计肥胖趋势对健康和经济的影响。

Application of the UK foresight obesity model in Ireland: the health and economic consequences of projected obesity trends in Ireland.

机构信息

Department of Epidemiology and Public Health, University College Cork, Cork, Ireland.

出版信息

PLoS One. 2013 Nov 13;8(11):e79827. doi: 10.1371/journal.pone.0079827. eCollection 2013.

Abstract

BACKGROUND

Given the scale of the current obesity epidemic and associated health consequences there has been increasing concern about the economic burden placed on society in terms of direct healthcare costs and indirect societal costs. In the Republic of Ireland these costs were estimated at €1.13 billion for 2009. The total direct healthcare costs for six major obesity related conditions (coronary heart disease & stroke, cancer, hypertension, type 2 diabetes and knee osteoarthritis) in the same year were estimated at €2.55 billion. The aim of this research is to project disease burden and direct healthcare costs for these conditions in Ireland to 2030 using the established model developed by the Health Forum (UK) for the Foresight: Tackling Obesities project.

METHODOLOGY

Routine data sources were used to derive incidence, prevalence, mortality and survival for six conditions as inputs for the model. The model utilises a two stage modelling process to predict future BMI rates, disease prevalence and costs. Stage 1 employs a non-linear multivariate regression model to project BMI trends; stage 2 employs a microsimulation approach to produce longitudinal projections and test the impact of interventions upon future incidence of obesity-related disease.

RESULTS

Overweight and obesity are projected to reach levels of 89% and 85% in males and females respectively by 2030. This will result in an increase in the obesity related prevalence of CHD & stroke by 97%, cancers by 61% and type 2 diabetes by 21%. The direct healthcare costs associated with these increases will amount to €5.4 billion by 2030. A 5% reduction in population BMI levels by 2030 is projected to result in €495 million less being spent in obesity-related direct healthcare costs over twenty years.

DISCUSSION

These findings have significant implications for policy, highlighting the need for effective strategies to prevent this avoidable health and economic burden.

摘要

背景

鉴于当前肥胖症的规模及其对健康造成的相关影响,人们越来越关注肥胖症给社会带来的经济负担,包括直接医疗成本和间接社会成本。在爱尔兰共和国,2009 年这方面的成本估计为 11.3 亿欧元。同年,六种主要肥胖相关疾病(冠心病和中风、癌症、高血压、2 型糖尿病和膝骨关节炎)的直接医疗总成本估计为 25.5 亿欧元。本研究旨在利用健康论坛(英国)为 Foresight:Tackling Obesities 项目开发的既定模型,预测爱尔兰到 2030 年这些疾病的疾病负担和直接医疗成本。

方法

使用常规数据源获取六种疾病的发病率、患病率、死亡率和生存率,作为模型的输入。该模型利用两阶段建模过程来预测未来的 BMI 率、疾病流行率和成本。第一阶段采用非线性多元回归模型预测 BMI 趋势;第二阶段采用微观模拟方法生成纵向预测,并测试干预措施对肥胖相关疾病未来发病率的影响。

结果

超重和肥胖预计将分别在男性和女性中达到 89%和 85%的水平。这将导致冠心病和中风的肥胖相关患病率增加 97%、癌症增加 61%、2 型糖尿病增加 21%。到 2030 年,与这些增长相关的直接医疗成本将达到 54 亿欧元。预计到 2030 年,人口 BMI 水平降低 5%,在 20 年内与肥胖相关的直接医疗成本将减少 4.95 亿欧元。

讨论

这些发现对政策具有重大意义,突显了需要采取有效的策略来预防这种可避免的健康和经济负担。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dd8a/3827424/c015d8ea2b7f/pone.0079827.g001.jpg

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