间接成本构成肥胖症总经济负担的主要部分：一项基于芬兰人群的队列研究。

Indirect costs constitute a major part of the total economic burden of obesity: a Finnish population-based cohort study.

作者信息

Vesikansa Aino, Mehtälä Juha, Aspholm Susanna, Kallio-Grönroos Kirsi, Mutanen Katja, Lundqvist Annamari, Laatikainen Tiina, Saukkonen Tero, Pietiläinen Kirsi H

机构信息

MedEngine Oy, Eteläranta 14, 00100, Helsinki, Finland.

Novo Nordisk Farma Oy, Espoo, Finland.

出版信息

BMC Public Health. 2025 May 10;25(1):1739. doi: 10.1186/s12889-025-22978-9.

DOI:10.1186/s12889-025-22978-9

PMID:40349009

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12065301/

Abstract

BACKGROUND

The growing prevalence of overweight and obesity (OB) poses a considerable economic burden worldwide. However, nationally representative, detailed analyses estimating the total burden of OB are few. We characterized direct, indirect, and total costs of overweight and obesity in a population-based cohort of Finnish adult individuals and evaluated the additional total costs attributed to overweight and obesity.

METHODS

The study cohort included 5,587 randomly-selected individuals (≥18 years of age) who participated in the national FinHealth 2017 health examination survey. The main study group consisted of working-age individuals (18-64 years of age; n = 3,914). Individual-level data were collected from the nationwide registers by the Finnish Institute for Health and Welfare (healthcare resource utilization), Social Insurance Institution of Finland (prescription medications, sick leaves, disability pensions, rehabilitation periods), and Statistics Finland (deaths). Indirect costs were calculated using the Human Capital Approach, and direct costs were based on the medication purchases and healthcare resource use.

RESULTS

The mean annual indirect costs were €1,683 (SD, €6,395) per person for the working-age individuals with normal-weight (NW), €2,957 (€8,797) for individuals with overweight (OW), €4,488 (€11,607) for individuals with class I obesity (OBI), and €4,654 (€11,383) for individuals with class II-III obesity (OBII-III). The mean annual total (direct + indirect) costs were €3,314 (SD, €8,358) per person in the NW, €4,902 (€10,747) in the OW, €7,129 (€14,313) in the OBI, and €7,372 (€14,423) in the OBII-III groups. Compared with individuals with NW, OW was associated with 31% (rate ratio, RR, 1.31; 95% CI, 1.09-1.58; p = 0.005), OBI with 83% (RR, 1.83; 95% CI, 1.46-2.28; p < 0.001), and OBII-III with 95% (RR, 1.95; 95% CI, 1.48-2.55; p < 0.001) higher total costs in working-age individuals. When adjusted for age and sex, the predicted total annual cost difference per person was €1,124 for OW, €3,002 for OBI, and €3,443 for OBII-III compared with a person with NW.

CONCLUSIONS

Indirect costs constitute a major part of the total costs of obesity in the working-age population. Compared with NW, the total costs are significantly higher not only for severe obesity, but also for OW and OBI.

摘要

背景

超重和肥胖（OB）患病率的不断上升给全球带来了相当大的经济负担。然而，进行全国代表性的、详细估算肥胖总负担的分析却很少。我们对芬兰成年人群体中基于人群队列的超重和肥胖的直接、间接及总成本进行了特征描述，并评估了超重和肥胖导致的额外总成本。

方法

研究队列包括5587名随机选取的18岁及以上成年人，他们参与了2017年全国芬兰健康（FinHealth）体检调查。主要研究组由工作年龄个体（18 - 64岁；n = 3914）组成。个体层面的数据由芬兰健康与福利研究所（医疗资源利用情况）、芬兰社会保险机构（处方药、病假、残疾抚恤金、康复期）以及芬兰统计局（死亡情况）从全国登记处收集。间接成本采用人力资本法计算，直接成本基于药品购买和医疗资源使用情况。

结果

正常体重（NW）的工作年龄个体每人每年的平均间接成本为1683欧元（标准差6395欧元），超重（OW）个体为2957欧元（8797欧元），I级肥胖（OBI）个体为4488欧元（11607欧元），II - III级肥胖（OBII - III）个体为4654欧元（11383欧元）。NW组每人每年的平均总（直接 + 间接）成本为3314欧元（标准差8358欧元），OW组为4902欧元（10747欧元），OBI组为7129欧元（14313欧元），OBII - III组为7372欧元（14423欧元）。与NW个体相比，OW个体的总成本高出31%（率比，RR，1.31；95%置信区间，1.09 - 1.58；p = 0.005），OBI个体高出83%（RR，1.83；95%置信区间，1.46 - 2.28；p < 0.001），OBII - III个体高出95%（RR，1.95；95%置信区间，1.48 - 2.55；p < 0.001）。在对年龄和性别进行调整后，与NW个体相比，OW个体每人每年预测的总成本差异为1124欧元，OBI个体为3002欧元，OBII - III个体为3443欧元。