中国超重和肥胖造成相关慢性疾病的经济负担研究

Economic burden of obesity related chronic diseases in China

目的评价由超重和肥胖造成的4种慢性疾病(高血压、糖尿病、冠心病、脑卒中)的直接经济负担,预测不同超重和肥胖率比值下的医疗负担变化。方法利用2002年中国居民营养与健康状况调查、2003年国家第三次卫生服务需求调查等相关资料,分别计算与超重和肥胖相关的4种慢性疾病的患病相对风险和人群归因危险度百分比,计算4种慢性疾病的直接疾病负担;根据人群归因危险度百分比计算超重和肥胖造成4种慢性病的直接经济负担。结果2003年中国超重和肥胖所造成的高血压、糖尿病、冠心病、脑卒中的直接经济负担分别为89．7、25．5、22．6和73．3亿元,4种病合计归因于超重和肥胖的直接经济负担高达211．1亿元人民币,占4种病合计直接疾病负担的25．5％。如果不采取相应措施,当超重与肥胖率比值达到1．1:1时,归因于超重和肥胖导致4种病的直接经济负担将达到369．9亿元,将比2003年上升75．2％。结论目前超重和肥胖所造成的高血压、糖尿病、冠心病、脑卒中的直接经济负担,分别占2003年中国卫生总费用和医疗总费用的3．2％和3．7％。

Objective To estimate annual direct medical costs of chronic diseases attributable to overweight and obesity among Chinese adults in China and to predict the medical costs if the situation of overweight and obesity is not under control. Methods Using data from the 2002 National Nutrition and Health Survey （n = 39 834）, the prevalence rates regarding overweight （24≤BMI〈 28） and obesity （BMI≥28）, population attributable risk （PAR） for hypertension, type 2 diabetes, coronary heart disease, and stroke, were calculated. Data from the 2003 National Health Services Survey （n = 143 521 ） was used to derive direct medical costs including costs for outpatient visits, physician services, inpatient stays, rehabilitation services, nursing fees, and medications. The medical costs attributable to overweight and obesity were estimated through multiplying the disease costs by PAR for each disease. Results The total medical cost attributable to overweight and obesity was estimated at 21.11 billion yuan （RMB） , accounting for 25.5% of the total medical costs for the four chronic diseases, or 3.7% of the national total medical costs in 2003. The medical cost associated with overweight and obesity would be increased to 37.0 billion yuan （RMB）, a 75.2% increase if the situation of obesity got worsened in the future. Conclusion The high economic burden of overweight and obesity calls for urgent need to develop effective interventions in order to prevent further worsening of the situation and to minimize the economic burden of obesity-related diseases.