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COST OF ILLNESS STUDIES. PREVALENCE-BASED ANALYSES COSTS INCURRED DURING YEAR BY PERSONS WITH A PARTICULAR ILLNESS ESTIMATES MAGNITUDE OF DISEASE COSTS ON ANNUAL BASIS ASSESSES ECONOMIC BURDEN ATTRIBUTABLE TO ACUTE OR TRANSIENT CONDITIONS

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Cost of illness studies
COST OF ILLNESS STUDIES

  • PREVALENCE-BASED ANALYSES

    • COSTS INCURRED DURING YEAR BY PERSONS WITH A PARTICULAR ILLNESS

    • ESTIMATES MAGNITUDE OF DISEASE COSTS ON ANNUAL BASIS

    • ASSESSES ECONOMIC BURDEN ATTRIBUTABLE TO ACUTE OR TRANSIENT CONDITIONS

    • DOES NOT QUANTIFY LONG-TERM CONSEQUENCES OF BEHAVIOR OR ILLNESS

      --- Colditz, 1992


  • INCIDENCE-BASED ANALYSES

    • REQUIRES RELIABLE ESTIMATES OF THE INCIDENCE OF DISEASE ATTRIBUTABLE TO OBESITY AT EACH AGE AND FOR EACH GENDER

    • CAN PROVIDE ESTIMATES FOR THE LIFETIME COST OF OBESITY

      • - -- Colditz, 1992


Economic costs
ECONOMIC COSTS

  • DIRECT COSTS

    • VALUE OF RESOURCES

    • PERSONAL HEALTH CARE, HOSPITAL CARE, PROFESSIONAL SERVICES, MEDICATIONS)

  • INDIRECT COSTS

    • VALUE OF LOST OUTPUT DUE TO MORBIDITY (WAGES LOST)OR MORTALITY (VALUE OF FUTURE EARNINGS LOST)

      • --- Colditz, 1992


Economic cost of obesity
ECONOMIC COST OF OBESITY

  • NIDMM -11.5 BILLION

  • GALL BLADDER DISEASE 2.4 BILLION

  • CVD (EXCLUDING HTN) 22.2 BILLION

  • HTN 1.5 BILLION

  • CANCER 1.9 BILLION

    • TOTAL COST = $39.3 BILLION OR 5.5% OF TOTAL COSTS OF ILLNESS IN 1986

      • ----Colditz, 1992


REVISED ESTIMATE OF COST BY INCLUDING MUSCULOSKELETAL DISEASES (1990)DIRECT COST OF TREATING OBESITY IN THE US IS $45.8 BILLION OR 6% OF THE TOTAL EXPENDITURE OF HEALTH CARE IN US---Wolf and Colditz, 1994


UK DISEASES (1990)

Cost of treating obesity in UK estimated at 195 million pounds

---West, 1994


Uk 2002
UK (2002) DISEASES (1990)

  • Cost of obesity (BMI greater than 30) was around 3340-3724 million pounds

  • If costs of being overweight are included (BMI 25-30) then the total annual cost of obesity and overweight would be around 6.6- 7.4 billion pounds

  • 2.3- 2.6% of total net National Health Service expenditure in 2001-2002


Uk 2002 continued
UK 2002 (continued) DISEASES (1990)

  • Lost earnings 2350-2600 million pounds

  • 34,000 deaths annually attributable to obesity

  • Probability of being in employment is significantly lower (up to 25%) for obese compared to those of normal weight

  • Obese may be discriminated in labor market

  • Obese may earn less and have lower education

    • -----McCormick et al, 2006


Health care costs of obesity in new zealand
HEALTH CARE COSTS OF OBESITY IN NEW ZEALAND DISEASES (1990)

  • ANALYSIS USING SAME ILLNESSES (NIDDM, CHD, HTN, GALLSTONE DISEASE, BREAST AND COLON CANCER)

    • NZ$135MILLION OR 2.5% OF TOTAL HEALTH CARE COSTS 1991

      • ----Swinburn et al., 1997


STUDIES USING POPULATION ATTRIBUTABLE FRACTIONS DISEASES (1990)PAF = PRODUCT OF RELATIVE RISK AND PREVALENCE RISK FACTORTHE PAF CAN BE USED TO CACULATE THE DIRECT COST OF TREATING OBESITY


Studies utilizing population attributable fractions
STUDIES UTILIZING POPULATION ATTRIBUTABLE FRACTIONS DISEASES (1990)

  • PAF CAN BE CALCULATED TO ESTIMATE DIRECT COST OF TREATING co-morbidities

    • Segal et al., 1994 (Australia) $A395 million

    • Levy et al., 1995 (France, 1990) FFr12 billion or 2% of the French health care costs

    • Seidell, 1995 (Netherlands) overweigt and obesity account for 4% of the total Dutch health care costs

      • ---Hughes and McGuire, 1997



Body mass and health care expenditures
BODY MASS AND HEALTH CARE EXPENDITURES DISEASES (1990)

  • MEDSTAT STUDY OF 16,217 INDIVIDUALS, 18-65

  • NATIONAL MEDICAL EXPENDITURE SURVEY DATA

    • USE OF ANY HEALTH CAR SERVICE AND EXPENDITURES

    • USE OF INPATIENT SERVICES AND EXPENDITURES

    • USE OF OUTPATIENT SERVICES AND EXPENDITURES

    • USE OF PRESCRIPTION MEDS AND EXPENDITURES

      • ---Heithoff et al., 1997


  • STRONG RELATIONSHIPS BETWEEN BODY MASS AND THE LIKELIHOOD OF USING HEALTH CARE SERVICES AND EXPENDITURES

  • ASSOCIATION WAS GREATER AMONG MALES

  • IDEAL BODY MASS WAS ASSOCIATED WITH 6.3% TO 36.1% LOWER ANNUAL HEALTH CARE EXPENDITURES (FEMALES) AND 3.6 TO 18.2% LOWERE EXPENDITURES IN MALES

    ---Heithoff et al, 1997


Conclusion
CONCLUSION USING HEALTH CARE SERVICES AND EXPENDITURES

  • Health care expenditures increase as weight deviates from the ideal

  • Increased expenditures and BMI relates to association of body mass to chronic illness especially diabetes and HTN

    ---Heithoff et al, 1997


Impact of obesity and overweight in japan
IMPACT OF OBESITY AND OVERWEIGHT IN JAPAN USING HEALTH CARE SERVICES AND EXPENDITURES

  • U-SHAPED ASSOCIATION BETWEEN BMI AND TOTAL MEDICAL COSTS

  • MEAN TOTAL COSTS WERE 9.8% GREATER AMONG THE OVERWEIGHT

  • STATISTICALLY INCREASED MORTALITY RISK IN OBESE WOMEN AND LEAN MEN AND WOMEN

  • STATISTICALLY SIG RELATIONSHIP BETWEEN EXCESS WEIGHT AND INCREASED RISK IN WOMEN OF ALL CANCERS

    • ----Kuriyama, et al., 2006


Health care costs of obesity in new zealand1
HEALTH CARE COSTS OF OBESITY IN NEW ZEALAND USING HEALTH CARE SERVICES AND EXPENDITURES

  • ANALYSIS USING SAME ILLNESSES (NIDDM, CHD, HTN, GALLSTONE DISEASE, BREAST AND COLON CANCER)

    • NZ$135MILLION OR 2.5% OF TOTAL HEALTH CARE COSTS 1991

      • ----Swinburn et al., 1997


Indirect costs
INDIRECT COSTS USING HEALTH CARE SERVICES AND EXPENDITURES

  • Colditz --indirect cost from lost productivity $20 billion for US in 1986 and $23 billion in updated study

  • Sjostrom et al., 1992--- level of sicknees absence was 1.4-2.4 times higher in obese individuals and number on disability pension 1.5-2.8 times higher (survey data)

  • Whole Swedish population--- 7% total productivity loss due to obesity

    • -----Hughes and McGuire, 1997


Cost of obesity model
COST OF OBESITY MODEL USING HEALTH CARE SERVICES AND EXPENDITURES

  • PATIENT CHARACTERISTICS (AGE, SEX, BMI)

    • Stage 1

  • CARDIOVASCULAR RISK PROFILE (HTN, HYPERCHOLESTEROLEMIA, TYPE II DIABETES)---management ($)

    • Stage 2

  • CARDIOVASCULAR DISEASE (CHD, STROKE)

    ----treatment of CHD, STROKE($)

    ---Thompson et al., 1999


  • Inflation adjusted obesity attributable increase in per capita health care spending 1987 2001
    Inflation-Adjusted Obesity Attributable Increase in Per Capita Health Care Spending1987-2001

    • Obesity accounted for 27 percent of the growth in real per capita spending between 1987 and 2001

    • Prevalence of obesity increased by 10.3 percentage points—to nearly 24 percent of the adult population

    • Costs incurred by obese were 37 percent higher than costs for those with normal weight

      • ---Thorpe, et al., 2004


    Health expenditures in overweight and obese children
    HEALTH EXPENDITURES IN OVERWEIGHT AND OBESE CHILDREN Capita Health Care Spending

    • Retrospective study

    • Used claims data from a large pediatric delivery system

    • Urban academic children’s hospital

    • Outcome measures: Dx obesity, primary care visits, ER, lab use, health care charges

      ---Hampl, et al, 2007


    Health expenditures in overweight and obese children continued
    HEALTH EXPENDITURES IN OVERWEIGHT AND OBESE CHILDREN (continued)

    • Overweight and obese children and adolescents have significantly more lab eval and higher charges


    Global epidemics of obesity and diabetes
    GLOBAL EPIDEMICS OF OBESITY AND DIABETES (continued)

    • 7 OF 10 OF THE COUNTRIES WITH THE GREATEST NUMBER OF DIABETICS ARE IN THE GLOBAL SOUTH

    • WITHIN THE NEXT TWO DECADES, THE NUMBER OF PESONS LIIVING WITH DIABETES IN BRAZIL, CHINA AND INDIA IS PROJECTED TO INCREASE AT NEARLY TWICE THE RATE OBSERVED IN THE US

    • GREATER INCIDENCE AT EARLIER STAGES OF LIFE

    • NEARLY ONE OUT OF EVERY THREE HOSPITAL BED-DAYS IN LATIN AMERICA ARE OCCUPIED FOR DIABETES-RELATED CAUSES

      • ---Yach, Stuckler and Brownell, 2006


    Global epidemics of obesity and diabetes continued
    GLOBAL EPIDEMICS OF OBESITY AND DIABETES (continued) (continued)

    • Diabetics in India: 15-25% of household income is required to cover treatment costs

    • Tanzania: costs amount to 25% of minimum wage or 20 times the per capita health expenditure

    • China: 30% of poor households attributed their poverty to healthcare costs

      ---Yach, Stuckler and Brownell, 2006


    Discussion of limitations of cost of illness studies
    DISCUSSION OF LIMITATIONS OF COST-OF-ILLNESS STUDIES (continued)

    • “Economics and Obesity: Costing the Problem or Evaluating Solutions”

      • Larissa Roux and Cam Donaldson

        Obesity Research v 12 no. 2 February 2004





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