Department of Social Medicine and Health Education, School of Public Health, Nanjing Medical University, 101 Longmian Avenue, Nanjing, 211166, Jiangsu, P.R. China.
Institute of Healthy Jiangsu Development, Nanjing Medical University, Nanjing, China.
BMC Public Health. 2023 Oct 5;23(1):1927. doi: 10.1186/s12889-023-16855-6.
The prevalence of abnormal weight is on the rise, presenting serious health risks and socioeconomic problems. Nonetheless, there is a lack of studies on the medical cost savings that can be attained through the mitigation of abnormal weight. The aim of this study was to estimate the impact of abnormal weight on healthcare costs in China.
The study employed a 4-wave panel data from China Family Panel Studies (CFPS) between 2012 and 2018 (11,209 participants in each wave). Inpatient, non-inpatient and total healthcare costs were outcome variables. Abnormal weight is categorized based on body mass index (BMI). Initially, the two-part model was employed to investigate the impact of overweight/obesity and underweight on healthcare utilisation and costs, respectively. Subsequently, the estimated results were utilised to calculate the overweight/obesity attributable fraction (OAF) and the underweight attributable fraction (UAF).
In 2018, healthcare costs per person for overweight and obese population were estimated to be $607.51 and $639.28, respectively, and the underweight population was $755.55. In comparison to people of normal weight, individuals who were overweight/obese (OR = 1.067, p < 0.05) was more likely to utilise healthcare services. Overweight/obesity attributable fraction (OAF) was 3.90% of total healthcare costs and 4.31% of non-inpatient costs. Overweight/obesity does not result in additional healthcare expenditures for young people but increases healthcare costs for middle-aged adults (OAF = 7.28%) and older adults (OAF = 6.48%). The non-inpatient cost of underweight population was significantly higher than that of normal weight population (β = 0.060,p < 0.1), but the non-inpatient health service utilisation was not significantly affected.
Abnormal weight imposes a huge economic burden on individuals, households and the society. Abnormal weight in Chinese adults significantly increased healthcare utilisation and costs, particular in non-inpatient care. It is recommended that government and relevant social agencies provide a better social environment to enhance individual self-perception and promote healthy weight.
超重的发病率不断上升，给健康和社会经济带来了严重的威胁。尽管如此，目前对于通过减轻体重来节省医疗费用的相关研究还比较匮乏。本研究旨在评估超重对中国医疗费用的影响。
本研究使用了 2012 年至 2018 年期间中国家庭追踪调查（CFPS）的 4 期面板数据（每期 11209 名参与者）。住院、非住院和总医疗费用是本研究的结果变量。根据体重指数（BMI）将超重/肥胖和体重不足分类。首先，我们使用两部分模型分别研究超重/肥胖和体重不足对医疗利用和费用的影响。随后，我们使用估计结果计算超重/肥胖归因分数（OAF）和体重不足归因分数（UAF）。
2018 年，超重和肥胖人群的人均医疗费用估计分别为 607.51 美元和 639.28 美元，而体重不足人群的人均医疗费用为 755.55 美元。与体重正常的人相比，超重/肥胖的人（OR=1.067，p<0.05）更有可能利用医疗服务。超重/肥胖归因分数（OAF）占总医疗费用的 3.90%，占非住院费用的 4.31%。超重/肥胖不会导致年轻人的医疗费用增加，但会增加中年成年人（OAF=7.28%）和老年成年人（OAF=6.48%）的医疗费用。体重不足人群的非住院费用明显高于体重正常人群（β=0.060，p<0.1），但非住院卫生服务利用并未受到显著影响。
超重给个人、家庭和社会带来了巨大的经济负担。中国成年人的超重显著增加了医疗服务的利用和费用，尤其是非住院护理。建议政府和相关社会机构提供更好的社会环境，增强个人自我认知，促进健康体重。
