Medical care expenditure associated with body mass index in Japan: the Ohsaki Study
Medical care expenditure associated with body mass index in Japan: the Ohsaki Study
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DOI：
10.1038/sj.ijo.0802021
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发表时间：
2002-08-01
影响因子：
4.9
通讯作者：
Hisamichi, S
中科院分区：
文献类型：
--
作者：
Kuriyama, S;Tsuji, I;Hisamichi, S
目的：研究日本人身体质量指数（BMI）对医疗服务使用及其费用的影响。设计：一项基于人群的前瞻性队列研究，研究时间为1995年至1998年，研究对象为41467名年龄在40 - 79岁之间的日本成年人。在随访的第一年死亡或基线时报告患有癌症、心肌梗死、中风或肾脏疾病的受试者被排除在外。测量：医疗服务的使用及其费用，实际收费，通过与国民健康保险索赔历史档案的联系，调整吸烟，饮酒和身体功能状况。结果：BMI与总医疗费用呈u型相关。在BMI为21.0 - 22.9 kg /m(2)时，发现曲线最低点。相对于最低点，bmi为25.0-29.9的患者总成本高出9.8%（比率比，1.10；95%可信区间（CI）， 1.03-1.17）， bmi为30.0或更高的患者总成本高出22.3%（比率比，1.22;95% CI, 1.08-1.37）。在本研究中，超重（BMI为25.0-29.9kg/m(2)）和肥胖（BMI为30.0 kg/m(2)或更高）造成的估计超额直接成本占卫生总支出的3.2%，在西方国家报告的范围内（0.7-6.8%）。结论：我们的前瞻性数据表明，超重和肥胖对日本医疗费用的影响与西方国家一样大，尽管日本人口的平均BMI要低得多。
OBJECTIVE: To examine the impact of body mass index (BMI) upon medical care use and its costs in Japan.DESIGN: A population-based prospective cohort study from 1995 to 1998,SUBJECTS: A cohort of 41 967 Japanese adults aged 40 - 79 y. Subjects who died during the first year of follow-up, or who at baseline reported having had cancer, myocardial infarction, stroke or kidney disease were excluded.MEASUREMENTS: Medical care use and its costs, actual charges, by linkage with the National Health Insurance claim history files after adjustment of smoking, drinking and physical functioning status.RESULTS: There was a U-shaped association between BMI and total medical costs. The nadir of the curve was found at a BMI of 21.0 - 22.9 kg /m(2). Relative to the nadir, total costs were 9.8% greater among those with BMIs of 25.0-29.9 (rate ratio, 1.10; 95% confidence interval (CI), 1.03-1.17), and 22.3% greater among those with BMIs of 30.0 or higher (rate ratio, 1.22; 95% CI, 1.08-1.37). Estimated excess direct costs attributable to overweight (BMI of 25.0-29.9kg/m(2)) and obesity (BMI of 30.0 kg/m(2) or higher) represent 3.2% of total health expenditure in the present study, which is within the range reported in Western countries (0.7-6.8%).CONCLUSION: Our prospective data demonstrate that the impact of overweight and obesity upon medical care costs in Japan is as large as in Western countries, despite the much lower mean BMI in Japanese populations.