The economic burden of physical inactivity: a global analysis of major non-communicable diseases
The economic burden of physical inactivity: a global analysis of major non-communicable diseases
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DOI：
10.1016/s0140-6736(16)30383-x
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发表时间：
2016-09-24
期刊：
影响因子：
168.9
通讯作者：
Pratt, Michael
中科院分区：
文献类型：
--
作者：
Ding, Ding;Lawson, Kenny D.;Pratt, Michael
背景身体不活动的大流行与一系列慢性疾病和早期死亡有关。尽管有据可查的疾病负担，但在全球范围内，身体不活动的经济负担仍然没有验证。更好地了解经济负担，可以帮助为资源优先次序提供信息，并激励努力提高全球体育活动水平。直接医疗保健成本，生产力损失以及可归因于身体不活动的残疾调整的生命年度（DALYS），可估计具有标准化方法的估计，并以142个国家 /地区获得了93.2％的世界人群的最佳数据。估计了冠心病，中风，2型糖尿病，乳腺癌和结肠癌的直接医疗费用和大用于归因于身体不活跃的结肠癌。估计生产力损失，并具有与身体无效死亡率相关的摩擦成本方法。分析是基于可用国家的国家身体不活跃的普遍性，并且调整了可归因于每个疾病结果和全因死亡率的身体不活动相关的可归因于身体不活跃的人群。保守估计的，物理不活动成本的卫生保健系统国际$（INT $）在2013年全球530亿美元的私人收费和31.2美元的收费率，$ 1.2.2.2.2.2.2.2家庭为97亿美元。此外，与身体上的无活动死亡相关的死亡人数造成了137亿美元的生产率损失，而身体不活动造成了全球1340万人达利的造成。高收入国家的经济负担比例更大（占医疗保健成本的80.8％，间接成本的60.4％），而低收入和中等收入国家的疾病负担比例较大（占达利人的75.0％）。基于较不保守的假设的敏感性分析导致了更高的估计。诠释除了发病率和过早死亡率外，身体上的不活动还导致了实质性的经济负担。本文提供了进一步的理由，以优先考虑促进全球定期体育锻炼，这是减少非传染性疾病的综合策略的一部分。
Background The pandemic of physical inactivity is associated with a range of chronic diseases and early deaths. Despite the well documented disease burden, the economic burden of physical inactivity remains unquantified at the global level. A better understanding of the economic burden could help to inform resource prioritisation and motivate efforts to increase levels of physical activity worldwide.Methods Direct health-care costs, productivity losses, and disability-adjusted life-years (DALYs) attributable to physical inactivity were estimated with standardised methods and the best data available for 142 countries, representing 93.2% of the world's population. Direct health-care costs and DALYs were estimated for coronary heart disease, stroke, type 2 diabetes, breast cancer, and colon cancer attributable to physical inactivity. Productivity losses were estimated with a friction cost approach for physical inactivity related mortality. Analyses were based on national physical inactivity prevalence from available countries, and adjusted population attributable fractions (PAFs) associated with physical inactivity for each disease outcome and all-cause mortality.Findings Conservatively estimated, physical inactivity cost health-care systems international $(INT$) 53.8 billion worldwide in 2013, of which $31.2 billion was paid by the public sector, $12.9 billion by the private sector, and $9.7 billion by households. In addition, physical inactivity related deaths contribute to $13.7 billion in productivity losses, and physical inactivity was responsible for 13.4 million DALYs worldwide. High-income countries bear a larger proportion of economic burden (80.8% of health-care costs and 60.4% of indirect costs), whereas low-income and middle-income countries have a larger proportion of the disease burden (75.0% of DALYs). Sensitivity analyses based on less conservative assumptions led to much higher estimates.Interpretation In addition to morbidity and premature mortality, physical inactivity is responsible for a substantial economic burden. This paper provides further justification to prioritise promotion of regular physical activity worldwide as part of a comprehensive strategy to reduce non-communicable diseases.