Department of Public Health, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan.
Department of Global Clinical Research, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan.
Obes Res Clin Pract. 2018 Sep-Oct;12(5):479-484. doi: 10.1016/j.orcp.2018.06.002. Epub 2018 Jun 22.
We aimed to reveal the association between body mass index (BMI) and medical costs in the current Japanese population, and to estimate the population attributable fraction (PAF) of medical costs due to overweight and obesity.
A generalized linear mixed model with log link function and gamma distribution was used to evaluate the association between BMI and medical costs in 34,537 beneficiaries of the National Health Insurance aged 40-69 years in Chiba City. Medical cost data were obtained from insurance claims submitted between April 2012 and March 2016. PAFs due to overweight (BMI ≥25.0 and <30.0kg/m) and obesity (BMI ≥30.0kg/m) were calculated.
Overweight and obesity were significant predictors of excessive medical costs in all age and sex groups. PAF due to overweight and obesity was estimated to be 9.62% (95% confidence interval, 8.52-10.73%). Additionally, PAFs in 40-59-year-old individuals (12.76% in men and 11.63% in women) were greater than those in 60-69-year-old subjects (6.55% in men and 7.80% in women) for both sexes.
In the Japanese population, overweight and obesity are an excessive financial burden with an estimated PAF of 9.62% of total medical costs.
本研究旨在揭示当前日本人群中体重指数(BMI)与医疗费用之间的关联,并估计超重和肥胖导致医疗费用的人群归因分数(PAF)。
采用对数链接函数和伽马分布的广义线性混合模型,评估了千叶市年龄在 40-69 岁的 34537 名国民健康保险受益人的 BMI 与医疗费用之间的关联。医疗费用数据来自 2012 年 4 月至 2016 年 3 月期间提交的保险索赔。计算了超重(BMI≥25.0 且<30.0kg/m)和肥胖(BMI≥30.0kg/m)所致的 PAF。
超重和肥胖是所有年龄和性别组过度医疗费用的显著预测因素。超重和肥胖导致的 PAF 估计为 9.62%(95%置信区间,8.52-10.73%)。此外,40-59 岁人群(男性为 12.76%,女性为 11.63%)的 PAF 大于 60-69 岁人群(男性为 6.55%,女性为 7.80%),无论性别如何。
在日本人群中,超重和肥胖是一个过度的经济负担,估计占总医疗费用的 9.62%。