Current estimates of the economic cost of obesity in the United States
Current estimates of the economic cost of obesity in the United States
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DOI：
10.1002/j.1550-8528.1998.tb00322.x
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发表时间：
1998-03-01
期刊：
影响因子：
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通讯作者：
Colditz, GA
中科院分区：
文献类型：
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作者：
Wolf, AM;Colditz, GA
这项研究的目的是更新和修订美国肥胖对经济影响的估计。采用基于患病率的疾病成本方法，以1995年美元计算，估计2型糖尿病、冠心病、高血压、胆囊疾病、乳腺癌、子宫内膜癌和结肠癌以及骨关节炎因肥胖造成的经济成本。此外，我们还使用1988年和1994年的全国健康访谈调查（NHIS），对因肥胖而导致的过度就诊、工作损失、活动受限和卧床天数进行了横断面分析。直接成本（个人保健、医院护理、医生服务、联合保健服务和药物）和间接成本（因发病率或死亡率导致生产力下降或停止而造成的产出损失）来自已发表的报告，并使用消费者价格指数（CPI）中的医疗部分作为直接成本，使用所有项目CPI作为间接成本，按1995年美元计算。人群归因危险度（PAR%）是从大型前瞻性研究中估计的。根据参加1988年NHIS的88，262名美国公民和参加1994年NHIS的80，261名美国公民估计了额外的工作损失天数，限制活动，卧床天数和医生就诊次数。样本权重已纳入NHIS分析，使这些数据可推广到美国人口。1995年，肥胖症造成的总费用达992亿美元。其中约516.4亿美元是直接医疗费用。使用1994年NHIS数据，由于肥胖（BMI大于或等于30）造成的生产力损失为39亿美元，反映了3920万天的工作损失。此外，1994年有2.39亿个活动受限日、8950万个卧床日和6260万次医生就诊可归因于肥胖。与1988年的国家健康调查数据相比，1994年的活动受限天数（36%）、卧床天数（28%）和工作损失天数（50%）大幅增加。从1988年到1994年，因肥胖而就诊的人数增加了88%。超重和肥胖的经济和个人健康成本是巨大的，损害了美国的健康。与肥胖相关的直接成本占美国国民健康支出的5.7%。
This study was undertaken to update and revise the estimate of the economic impact of obesity in the United States. A prevalence-based approach to the cost of illness was used to estimate the economic costs in 1995 dollars attributable to obesity for type 2 diabetes mellitus, coronary heart disease (CHD), hypertension, gallbladder disease, breast, endometrial and colon cancer, and osteoarthritis. Additionally and independently, excess physician visits, work-lost days, restricted activity, and bed-days attributable to obesity were analyzed cross-sectionally using the 1988 and 1994 National Health Interview Survey (NHIS). Direct (personal health care, hospital care, physician services, allied health services, and medications) and indirect costs (lost output as a result of a reduction or cessation of productivity due to morbidity or mortality) are from published reports and inflated to 1995 dollars using the medical component of the consumer price index (CPI) for direct cost and the all-items CPI for indirect cost. Population-attributable risk percents (PAR%) are estimated from large prospective studies. Excess work-lost days, restricted activity, bed-days, and physician visits are estimated from 88,262 U.S. citizens who participated in the 1988 NHIS and 80,261 who participated in the 1994 NHIS. Sample weights have been incorporated into the NHIS analyses, making these data generalizable to the U.S. population. The total cost attributable to obesity amounted to $99.2 billion dollars in 1995. Approximately $51.64 billion of those dollars were direct medical costs. Using the 1994 NHIS data, cost of lost productivity attributed to obesity (BMI greater than or equal to 30) was $3.9 billion and reflected 39.2 million days of lost work. In addition, 239 million restricted activity days, 89.5 million bed-days, and 62.6 million physician visits were attributable to obesity in 1994. Compared with 1988 NHIS data, in 1994 the number of restricted-activity days (36%), bed-days (28%), and work-lost days (50%) increased substantially. The number of physician visits attributed to obesity increased 88% from 1988 to 1994. The economic and personal health costs of overweight and obesity are enormous and compromise the health of the United States. The direct costs associated with obesity represent 5.7% of our National Health Expenditure in the United States.