Direct healthcare costs of sedentary behaviour in the UK
Direct healthcare costs of sedentary behaviour in the UK
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DOI：
10.1136/jech-2018-211758
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发表时间：
2019-07-01
影响因子：
6.3
通讯作者：
Tully, Mark A.
中科院分区：
文献类型：
--
作者：
Heron, Leonie;O'Neill, Ciaran;Tully, Mark A.
越来越多的证据表明，长期久坐行为增加了几种慢性健康状况和全因死亡的风险。久坐不动的行为在英国的成年人中很普遍。量化与久坐行为相关的成本是制定公共卫生政策的重要一步。方法在2016-2017年的1年期间估计与长期久坐行为（>= 6小时/天）相关的国民健康服务（NHS）成本。我们计算了5种健康结果（2型糖尿病、心血管疾病[CVD]、结肠癌、子宫内膜癌和肺癌）的人群归因分数（PAF）。由于合并症，对潜在的重复计算进行了调整。我们还使用PAF计算了由于长时间久坐行为导致的可避免死亡的全因死亡率。结果2016-2017年英国长时间久坐行为导致的NHS总成本为8亿磅，其中包括CVD支出（4.24亿磅）、2型糖尿病（2.81亿磅）、结肠癌（3000万磅）、肺癌（1900万磅）和子宫内膜癌（700万磅）。在对可能的重复计算进行调整后，估计总额为7亿磅。如果消除长时间的久坐行为，2016年可能避免69276例英国死亡。结论在对直接医疗保健成本的保守估计中，长时间的久坐行为给英国NHS造成了相当大的负担。决策者在优先考虑医疗资源和投资预防性公共卫生项目时可以使用这一估计。
Background Growing evidence indicates that prolonged sedentary behaviour increases the risk of several chronic health conditions and all-cause mortality. Sedentary behaviour is prevalent among adults in the UK. Quantifying the costs associated with sedentary behaviour is an important step in the development of public health policy.Methods National Health Service (NHS) costs associated with prolonged sedentary behaviour (>= 6 hours/day) were estimated over a 1-year period in 2016-2017 costs. We calculated a population attributable fraction (PAF) for five health outcomes (type 2 diabetes, cardiovascular disease [CVD], colon cancer, endometrial cancer and lung cancer). Adjustments were made for potential double-counting due to comorbidities. We also calculated the avoidable deaths due to prolonged sedentary behaviour using the PAF for all-cause mortality.Results The total NHS costs attributable to prolonged sedentary behaviour in the UK in 2016-2017 were pound 0.8 billion, which included expenditure on CVD ( pound 424 million), type 2 diabetes ( pound 281 million), colon cancer ( pound 30 million), lung cancer ( pound 19 million) and endometrial cancer ( pound 7 million). After adjustment for potential double-counting, the estimated total was pound 0.7 billion. If prolonged sedentary behaviour was eliminated, 69 276 UK deaths might have been avoided in 2016.Conclusions In this conservative estimate of direct healthcare costs, prolonged sedentary behaviour causes a considerable burden to the NHS in the UK. This estimate may be used by decision makers when prioritising healthcare resources and investing in preventative public health programmes.