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肥胖和代谢状态与增加的医疗资源和药物使用及成本有关:一项芬兰基于人群的研究。

Obesity and metabolic state are associated with increased healthcare resource and medication use and costs: a Finnish population-based study.

机构信息

MedEngine Oy, Eteläranta 14, 00130, Helsinki, Finland.

Novo Nordisk Farma Oy, Espoo, Finland.

出版信息

Eur J Health Econ. 2023 Jul;24(5):769-781. doi: 10.1007/s10198-022-01507-0. Epub 2022 Sep 5.

Abstract

AIM

To characterize healthcare resource (HCRU) and medication use and associated costs in individuals with obesity compared with individuals with normal weight or overweight in a population-based cohort of Finnish adults. The association between metabolic state and direct costs was also assessed.

METHODS

The study cohort included 5587 randomly selected individuals who participated in the national FinHealth 2017 health examination survey. Data on healthcare visits and hospital stays, including diagnoses (ICD-10), and purchases and costs of prescription medicines were collected from the nationwide registers by the Finnish Institute for Health and Welfare and Social Insurance Institution of Finland. The healthcare costs were calculated based on standard unit costs reported by the Finnish Institute for Health and Welfare.

RESULTS

The total annual direct costs were €2665 (SD €5673) and €1799 (SD €3874) per person with obesity and with normal weight or overweight, respectively. Obesity was associated with significantly increased total direct (age- and sex-adjusted cost rate ratio, RR, 1.356; p < 0.001), HCRU-related (1.273; p = 0.002), and medication (1.669; p < 0.001) costs. A vast majority (90%) of individuals with obesity were classified as metabolically unhealthy based on clinical measurements. The metabolically unhealthy state was associated with increased costs in individuals with obesity but not in individuals with normal weight or overweight.

CONCLUSION

Obesity is associated with a significant and complex direct cost burden to society, arising primarily from increased comorbidity. Metabolically healthy obesity is uncommon and obesity prevention and timely treatment should be of high priority to tackle the increasing burden of obesity.

摘要

目的

在芬兰成年人的基于人群的队列中,与正常体重或超重个体相比,肥胖个体的医疗资源(HCRU)和药物使用情况及其相关费用特征,并评估代谢状态与直接费用之间的关系。

方法

研究队列包括参加 2017 年全国 FinHealth 健康检查调查的 5587 名随机选择的个体。通过芬兰国家卫生与福利研究所和芬兰社会保险机构从全国范围内的登记处收集医疗访问和住院情况的数据,包括诊断(ICD-10)以及处方药的购买和费用。根据芬兰国家卫生与福利研究所报告的标准单位成本计算医疗费用。

结果

肥胖个体的年直接总成本分别为 2665 欧元(SD 5673 欧元)和 1799 欧元(SD 3874 欧元),而正常体重或超重个体的直接总成本分别为 1799 欧元(SD 3874 欧元)和 1799 欧元(SD 3874 欧元)。肥胖与总直接费用(年龄和性别调整后成本率比 RR,1.356;p<0.001)、HCRU 相关费用(1.273;p=0.002)和药物费用(1.669;p<0.001)显著增加相关。绝大多数(90%)肥胖个体根据临床测量结果被归类为代谢不健康。代谢不健康状态与肥胖个体的费用增加有关,但与正常体重或超重个体无关。

结论

肥胖与社会的显著和复杂的直接费用负担相关,主要源于合并症的增加。代谢健康型肥胖并不常见,肥胖预防和及时治疗应成为解决肥胖负担日益增加的重中之重。

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