Institute of Pharmaceutical Medicine (ECPM), University of Basel, Basel, Switzerland.
Winterthur Institute of Health Economics, Zurich University of Applied Sciences, Winterthur, Switzerland.
Scand J Med Sci Sports. 2019 Jan;29(1):95-104. doi: 10.1111/sms.13311. Epub 2018 Oct 15.
Physical inactivity is a major risk factor for numerous non-communicable diseases which dominate the overall burden of disease in Switzerland. We aimed to estimate the burden attributable to adult physical inactivity in Switzerland and its three culturally different language regions from a societal perspective in terms of disability-adjusted life years (DALYs), medical costs, and productivity losses. The burden of physical inactivity was estimated with a population attributable fractions (PAFs) approach. PAFs were calculated based on the prevalence of physical inactivity in the Swiss Health Survey and literature-based adjusted risk ratios of disease incidence. These PAFs were then applied to the total burden of the diseases related to physical inactivity. Physical inactivity was responsible for 2.0% (95%CI 1.7%-2.2%) of total DALYs lost and 1.2% (95%CI 1.0%-1.3%) of total medical costs in 2013. This is equivalent to 116 (95%CI 99-135) Swiss francs per capita per year. Productivity losses were valued at 117 (95%CI 94-142) Swiss francs per capita per year. The two diseases which caused the highest economic burden were low back pain and depression. The analysis of regional differences revealed that the per capita burden of physical inactivity is about twice as high in the French- and Italian-speaking regions compared to the German-speaking region. Reasons include a higher prevalence of physical inactivity, higher per capita health care spending, and higher disease prevalence. Cost-effectiveness analysis of related interventions should consider regional differences for optimal resource allocation in physical activity promotion policies.
身体活动不足是许多非传染性疾病的主要危险因素,这些疾病在瑞士的总疾病负担中占主导地位。我们旨在从社会角度,以残疾调整生命年(DALYs)、医疗费用和生产力损失来估计瑞士及其三种具有不同文化的语言地区成年人身体活动不足的负担。使用人群归因分数(PAFs)方法来估计身体活动不足的负担。PAFs 是根据瑞士健康调查中的身体活动不足患病率和基于文献的疾病发病率调整后的风险比计算得出的。然后,这些 PAFs 被应用于与身体活动不足相关疾病的总负担。身体活动不足导致 2013 年总 DALYs 损失的 2.0%(95%CI 1.7%-2.2%)和总医疗费用的 1.2%(95%CI 1.0%-1.3%)。这相当于每人每年 116(95%CI 99-135)瑞士法郎。生产力损失的价值为每人每年 117(95%CI 94-142)瑞士法郎。导致经济负担最高的两种疾病是下背痛和抑郁症。对区域差异的分析表明,与德语区相比,法语区和意大利语区的身体活动不足人均负担约为其两倍。原因包括身体活动不足的患病率较高、人均医疗保健支出较高以及疾病患病率较高。相关干预措施的成本效益分析应考虑区域差异,以便在身体活动促进政策中进行最佳资源分配。