Institute for Medical Technology Assessment (iMTA), Erasmus University Rotterdam, Rotterdam, the Netherlands.
Erasmus School of Health Policy & Management (ESHPM), Erasmus University Rotterdam, Rotterdam, the Netherlands.
Diabetes Obes Metab. 2023 Aug;25(8):2351-2361. doi: 10.1111/dom.15116. Epub 2023 May 24.
Estimating the burden of obesity in five European countries (Germany, Greece, the Netherlands, Spain and the UK) and the potential health benefits and changes in health care costs associated with a reduction in body mass index (BMI).
A Markov model was used to estimate the long-term burden of obesity. Health states were based on the occurrence of diabetes, ischaemic heart disease and stroke. Multiple registries and literature sources were used to derive the demographic, epidemiological and cost input parameters. For the base-case analyses, the model was run for a starting cohort of healthy obese people with a BMI of 30 and 35 kg/m aged 40 years to estimate the lifetime impact of obesity and the impact of a one-unit decrease in BMI. Different scenario and sensitivity analyses were performed.
The base-case analyses showed that total lifetime health care costs (for obese people aged 40 and BMI 35 kg/m ) ranged from €75 376 in Greece to €343 354 in the Netherlands, with life expectancies ranging from 37.9 years in Germany to 39.7 years in Spain. A one-unit decrease in BMI showed gains in life expectancy ranging from 0.65 to 0.68 year and changes in total health care costs varying from -€1563 to +€4832.
The economic burden of obesity is substantial in the five countries. Decreasing BMI results in health gains, reductions in obesity-related health care costs, but an increase in non-obesity related health care costs, which emphasizes the relevance of including all costs in decision making on implementation of preventive interventions.
估计五个欧洲国家（德国、希腊、荷兰、西班牙和英国）的肥胖负担，以及与体重指数（BMI）降低相关的潜在健康益处和医疗保健成本变化。
使用马尔可夫模型来估计肥胖的长期负担。健康状况基于糖尿病、缺血性心脏病和中风的发生情况。多项登记处和文献来源用于获得人口统计学、流行病学和成本输入参数。对于基础案例分析，模型针对 BMI 为 30 和 35kg/m、年龄为 40 岁的健康肥胖人群进行了运行，以估计肥胖的终身影响以及 BMI 降低一个单位的影响。进行了不同的情景和敏感性分析。
基础案例分析表明，总终身医疗保健成本（针对 40 岁和 BMI 为 35kg/m 的肥胖人群）范围从希腊的 75376 欧元到荷兰的 343354 欧元，预期寿命范围从德国的 37.9 年到西班牙的 39.7 年。BMI 降低一个单位可使预期寿命增加 0.65 至 0.68 年，总医疗保健成本变化从 -1563 欧元到+4832 欧元不等。
在这五个国家，肥胖的经济负担是巨大的。降低 BMI 可带来健康收益，降低与肥胖相关的医疗保健成本，但会增加与非肥胖相关的医疗保健成本，这强调了在实施预防干预措施的决策中纳入所有成本的重要性。
