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2018年巴西统一卫生系统中肥胖、高血压和糖尿病的归因成本

[Costs attributable to obesity, hypertension, and diabetes in the Unified Health System, Brazil, 2018Costos atribuibles a la obesidad, la hipertensión y la diabetes en el Sistema Único de Salud de Brasil, 2018].

作者信息

Nilson Eduardo Augusto Fernandes, Andrade Rafaella da Costa Santin, de Brito Daniela Aquino, de Oliveira Michele Lessa

机构信息

Ministério da Saúde Coordenação-Geral de Alimentação e Nutrição Brasília (DF) Brasil Ministério da Saúde, Coordenação-Geral de Alimentação e Nutrição, Brasília (DF), Brasil.

Ministério da Educação Fundo Nacional de Desenvolvimento da Educação (FNDE) Brasília (DF) Brasil Ministério da Educação, Fundo Nacional de Desenvolvimento da Educação (FNDE), Brasília (DF), Brasil.

出版信息

Rev Panam Salud Publica. 2020 Apr 10;44:e32. doi: 10.26633/RPSP.2020.32. eCollection 2020.

Abstract

OBJECTIVE

To estimate the cost attributable to arterial hypertension, diabetes and obesity in the Unified Health System of Brazil in 2018.

METHOD

The study estimated the cost attributable to non-communicable chronic diseases based on relative risk and population prevalence of hypertension, diabetes, and obesity, considering the cost of hospitalizations, outpatient procedures, and medications distributed by the SUS to treat these diseases. Cost data were obtained from SUS information systems. The analysis explored the cost of disease according to sex and age in the adult populatio.

RESULTS

The total cost of hypertension, diabetes, and obesity in the SUS reached R$ 3.45 billion (95%CI: 3.15-3.75) in 2018, that is, more than US$ 890 million. Of this amount, 59% referred to the treatment of hypertension, 30% to diabetes, and 11% to obesity. The age group from 30 to 69 years accounted for 72% of the total costs, and women accounted for 56%. When obesity was considered separately as a risk factor for hypertension and diabetes, the cost attributable to this diseases reached R$ 1.42 billion (95%CI: 0.98-1.87), i.e., 41% of the total cost.

CONCLUSIONS

The estimates of costs attributable to the main chronic diseases associated with inadequate diet revealed a heavy economic burden of these disorders for the SUS. The data show the need to prioritize integrated and intersectoral policies for the prevention and control of hypertension, diabetes, and obesity, and may support the advocacy for interventions such as fiscal and regulatory measures to ensure that the objectives of the United Nations Decade of Action on Nutrition are met.

摘要

目的

估算2018年巴西统一卫生系统中动脉高血压、糖尿病和肥胖症所致的费用。

方法

该研究基于高血压、糖尿病和肥胖症的相对风险及人群患病率,估算非传染性慢性病所致的费用,同时考虑了住院费用、门诊手术费用以及巴西统一卫生系统分发的治疗这些疾病的药物费用。费用数据来自巴西统一卫生系统信息系统。该分析探讨了成年人群中按性别和年龄划分的疾病费用。

结果

2018年,巴西统一卫生系统中高血压、糖尿病和肥胖症的总费用达到34.5亿雷亚尔(95%置信区间:31.5 - 37.5亿雷亚尔),即超过8.9亿美元。其中,59%用于高血压治疗,30%用于糖尿病治疗,11%用于肥胖症治疗。30至69岁年龄组占总费用的72%,女性占56%。当将肥胖症单独视为高血压和糖尿病的危险因素时,这些疾病所致的费用达到14.2亿雷亚尔(95%置信区间:9.8 - 18.7亿雷亚尔),即占总费用的41%。

结论

与饮食不良相关的主要慢性病所致费用的估算显示,这些疾病给巴西统一卫生系统带来了沉重的经济负担。数据表明,需要优先制定综合和跨部门政策来预防和控制高血压、糖尿病和肥胖症,并且可能支持倡导采取财政和监管措施等干预措施,以确保实现联合国营养问题行动十年的目标。

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