Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK; Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
Lancet Public Health. 2017 May;2(5):e214-e222. doi: 10.1016/S2468-2667(17)30062-2. Epub 2017 Apr 5.
Excess weight is associated with poor health and increased health-care costs. However, a detailed understanding of the effects of excess weight on total hospital costs and costs for different health conditions is needed.
Women in England aged 50-64 years were recruited into the prospective Million Women Study cohort in 1996-2001 through 60 NHS breast cancer screening centres. Participants were followed up and annual hospital costs and admission rates were estimated for April 1, 2006, to March 31, 2011, in relation to body-mass index (BMI) at recruitment, overall and for categories of health conditions defined by the International Classification of Diseases 10th revision chapter of the primary diagnosis at admission. Associations of BMI with hospital costs were projected to the 2013 population of women aged 55-79 years in England.
1 093 866 women who provided information on height and weight, had a BMI of at least 18·5 kg/m, and had no previous cancer at recruitment, were followed up for an average of 4·9 years from April 1, 2006 (12·3 years from recruitment), during which time 1·84 million hospital admissions were recorded. Annual hospital costs were lowest for women with a BMI of 20·0 kg/m to less than 22·5 kg/m (£567 per woman per year, 99% CI 556-577). Every 2 kg/m increase in BMI above 20 kg/m was associated with a 7·4% (7·1-7·6) increase in annual hospital costs. Excess weight was associated with increased costs for all diagnostic categories, except respiratory conditions and fractures. £662 million (14·6%) of the estimated £4·5 billion of total annual hospital costs among all women aged 55-79 years in England was attributed to excess weight (BMI ≥25 kg/m), of which £517 million (78%) arose from hospital admissions with procedures. £258 million (39%) of the costs attributed to excess weight were due to musculoskeletal admissions, mainly for knee replacement surgeries.
Excess body weight is associated with increased hospital costs for middle-aged and older women in England across a broad range of conditions, especially knee replacement surgery and diabetes. These results provide reliable up-to-date estimates of the health-care costs of excess weight and emphasise the need for investment to tackle this public health issue.
Cancer Research UK; Medical Research Council; National Institute for Health Research.
超重与健康状况不佳和医疗保健费用增加有关。然而，需要详细了解超重对总住院费用和不同健康状况费用的影响。
1996 年至 2001 年期间，通过 60 个 NHS 乳腺癌筛查中心，招募了英格兰年龄在 50-64 岁之间的女性参加前瞻性的百万女性研究队列。在 2006 年 4 月 1 日至 2011 年 3 月 31 日期间，根据入组时的体重指数（BMI）、总体以及按入院时主要诊断的国际疾病分类第 10 版章节定义的健康状况类别，对参与者进行了随访，并估算了年度住院费用和入院率。预计 BMI 与医院费用的关系将推广到 2013 年英格兰 55-79 岁的女性人群中。
109.3866 名提供身高和体重信息、BMI 至少为 18.5kg/m2 且入组前无癌症的女性被随访，平均随访时间为 4.9 年（自入组起 12.3 年），在此期间共记录了 184 万次住院。BMI 为 20.0kg/m2 至 22.5kg/m2 的女性每年的医院费用最低（每人每年 567 英镑，99%CI 556-577）。BMI 每增加 2kg/m2 以上 20kg/m2，与每年医院费用增加 7.4%（7.1-7.6）相关。超重与所有诊断类别相关的费用增加有关，除了呼吸系统疾病和骨折。在英格兰所有 55-79 岁的女性中，估计每年 45 亿英镑的总医院费用中，有 6.62 亿英镑（14.6%）归因于超重（BMI≥25kg/m2），其中 5.17 亿英镑（78%）来自有治疗的住院。归因于超重的费用中有 2.58 亿英镑（39%）是由肌肉骨骼疾病引起的，主要是膝关节置换手术。
在英格兰，中年和老年女性的超重与广泛的健康状况的住院费用增加有关，特别是膝关节置换手术和糖尿病。这些结果提供了超重导致的医疗保健费用的可靠最新估计，强调了需要投资来解决这一公共卫生问题。
英国癌症研究中心；医学研究委员会；国民健康保险制度。
