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澳大利亚糖尿病和肥胖症的成本。

The cost of diabetes and obesity in Australia.

作者信息

Lee Crystal Man Ying, Goode Brandon, Nørtoft Emil, Shaw Jonathan E, Magliano Dianna J, Colagiuri Stephen

机构信息

a Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders , University of Sydney , NSW , Australia.

b School of Public Health , Curtin University , Perth , WA , Australia.

出版信息

J Med Econ. 2018 Oct;21(10):1001-1005. doi: 10.1080/13696998.2018.1497641. Epub 2018 Jul 19.

Abstract

AIMS

To assess and compare the direct healthcare and non-healthcare costs and government subsidies by body weight and diabetes status.

METHODS

The Australian Diabetes, Obesity and Lifestyle study collected health service utilization and health-related expenditure data at the 2011-2012 follow-up surveys. Costing data were available for 4,409 participants. Unit costs for 2016-2017 were used where available or were otherwise inflated to 2016-2017 dollars. Age- and sex-adjusted costs per person were estimated using generalized linear models.

RESULTS

The annual total direct cost ranged from $1,998 per person with normal weight to $2,501 per person with obesity in participants without diabetes. For those with diabetes, total direct costs were $2,353 per person with normal weight, $3,263 per person with overweight, and $3,131 per person with obesity. Additional expenditure as government subsidies ranged from $5,649 per person with normal weight and no diabetes to $8,085 per person with overweight and diabetes. In general, direct costs and government subsidies were higher for overweight and obesity compared to normal weight, regardless of diabetes status, but were more noticeable in the diabetes sub-group. The annual total excess cost compared with normal weight people without diabetes was 26% for obesity alone and 46% for those with obesity and diabetes.

LIMITATIONS

Participants included in this study represented a healthier cohort than the Australian population. The relatively small sample of people with both obesity and diabetes prevented a more detailed analysis by obesity class.

CONCLUSION

Overweight and obesity are associated with increased costs, which are further increased in individuals who also have diabetes. Interventions to prevent overweight and obesity or reduce weight in people who are overweight or obese, and prevent diabetes, should reduce the financial burden.

摘要

目的

按体重和糖尿病状况评估并比较直接医疗保健和非医疗保健成本以及政府补贴。

方法

澳大利亚糖尿病、肥胖与生活方式研究在2011 - 2012年随访调查中收集了医疗服务利用情况和与健康相关的支出数据。共有4409名参与者的成本数据可用。如有2016 - 2017年的单位成本则使用该数据,否则将其通胀至2016 - 2017年美元价值。使用广义线性模型估计经年龄和性别调整后的人均成本。

结果

在无糖尿病的参与者中,每年人均直接成本从体重正常者的1998美元到肥胖者的2501美元不等。对于糖尿病患者,体重正常者的人均直接成本为2353美元,超重者为3263美元,肥胖者为3131美元。作为政府补贴的额外支出从体重正常且无糖尿病者的人均5649美元到超重且患糖尿病者的人均8085美元不等。总体而言,无论糖尿病状况如何,超重和肥胖者的直接成本和政府补贴均高于体重正常者,但在糖尿病亚组中更为明显。与无糖尿病的体重正常者相比,仅肥胖者的年度总额外成本为26%,肥胖且患糖尿病者为46%。

局限性

本研究纳入的参与者比澳大利亚总体人群更健康。肥胖且患糖尿病的人群样本相对较小,妨碍了按肥胖类别进行更详细的分析。

结论

超重和肥胖与成本增加相关,而在同时患有糖尿病的个体中成本进一步增加。预防超重和肥胖或使超重或肥胖者减重以及预防糖尿病的干预措施应能减轻经济负担。

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