Postgraduate Program in Food, Nutrition, and Health, Rio de Janeiro State University, Rio de Janeiro, RJ, Brazil.
International Center for Equity in Health, Federal University of Pelotas, Pelotas, Rio Grande do Sul, RS, Brazil.
BMC Public Health. 2022 Aug 2;22(1):1474. doi: 10.1186/s12889-022-13906-2.
Obesity, a complex public health problem, is generally associated with other chronic diseases. The association of obesity with health service utilization has been little investigated in low- and middle-income countries. This study aimed to analyze the association between obesity and health service utilization (considering those services related to hypertension and/or diabetes).
A cross-sectional, nationally-representative, study of Brazilians aged ≥18 years was conducted. Data from the National Health Survey (2013) for 59,402 individuals were analyzed, including measured weight and height. The association between body mass index (BMI) category (under/normal weight, overweight, and obesity) and health service utilization due to hypertension and/or diabetes was investigated using Poisson regression models (crude and adjusted). To analyze the health services utilization, the following variables were considered: 1) routine visits to a general doctor or health service; 2) referrals/consultations with a specialist; 3) prescribed exams done; and 4) hospital admission due to the disease or related complication. All analyses were stratified by sex.
Compared with under/normal-weight individuals, subjects with obesity (both male and female) made roughly double the use of all health care services assessed. Men with hypertension that had obesity had a higher risk of hospital admission (adjusted PR = 2.55; 95%CI 1.81-3.61), than those with under/normal weight. Women with diabetes that had obesity had more referrals/consultations with specialists (adjusted PR = 2.56; 95%CI 1.94-3.38), than those with under/normal weight.
The presence of obesity was associated with increased use of health care services for hypertension and/or diabetes, indicating greater demand for human resources and materials, and a greater burden on the national health system.
肥胖是一个复杂的公共卫生问题，通常与其他慢性疾病有关。在中低收入国家，肥胖与卫生服务利用之间的关系尚未得到充分研究。本研究旨在分析肥胖与卫生服务利用（考虑与高血压和/或糖尿病相关的服务）之间的关系。
本研究采用横断面、全国代表性的巴西成年人（≥18 岁）研究。分析了来自 2013 年全国健康调查（NHS）的 59402 名个体的数据，包括测量体重和身高。使用泊松回归模型（未调整和调整）分析了 BMI 类别（体重不足/正常、超重和肥胖）与高血压和/或糖尿病相关的卫生服务利用之间的关系。为了分析卫生服务利用，考虑了以下变量：1）常规就诊于全科医生或卫生服务；2）转诊/咨询专家；3）进行的规定检查；4）因疾病或相关并发症住院。所有分析均按性别分层。
与体重不足/正常的个体相比，肥胖（男性和女性）患者使用所有评估的卫生保健服务的次数大致增加了一倍。患有肥胖症的男性高血压患者住院的风险更高（调整后的 PR=2.55；95%CI 1.81-3.61），而体重不足/正常的患者则较低。患有肥胖症的女性糖尿病患者接受专家转诊/咨询的次数更多（调整后的 PR=2.56；95%CI 1.94-3.38），而体重不足/正常的患者则较少。
肥胖的存在与高血压和/或糖尿病卫生服务利用的增加有关，表明对人力资源和材料的需求增加，对国家卫生系统的负担增加。
