计算肥胖的终身成本:基于英国国家数据的分析
Adrian Heald1,2, Michael Stedman3, Anthony A Fryer4
1The School of Medicine and Manchester Academic Health Sciences Centre, Manchester University, Manchester, UK.
Diabetes, obesity & metabolism
|February 5, 2024
概括
肥胖症显著增加死亡率和医疗保健成本,致病性肥胖个体损失了相当大的质量调整寿命年 (QALY). 这些发现强调了需要长期的体重管理干预措施,以减轻这些终身影响.
科学领域:
- 公共卫生 公共卫生
- 卫生经济学 卫生经济学
- 流行病学 流行病学
背景情况:
- 肥胖是所有原因死亡率和医疗保健资源利用率 (HCRU) 的主要决定因素.
- 年龄,性别和社会经济贫困等人口因素显著影响与肥胖相关的结果.
- 了解与肥胖相关的终身成本对于公共卫生政策和资源分配至关重要.
研究的目的:
- 量化英国不同人口群体和地理区域中肥胖的终身成本.
- 估计肥胖对死亡率和HCRU的影响,考虑各种身体质量指数 (BMI) 类.
- 在终身成本的背景下,评估减肥干预措施的潜在经济效益.
主要方法:
- 使用了人口,死亡率和HCRU的国家数据,按年龄,性别和贫困分层.
- 应用肥胖类流行数据来估计每个综合护理委员会 (ICB) 的生命损失年数和终身HCRU.
- 使用2019年的数据和2022/23年HCRU值,比较了四个BMI类别 (正常/体重不足,超重,肥胖类 I/II,肥胖类 III) 的结果.
主要成果:
- 肥胖与大量生命年损失有关,BMI≥40的个体平均损失6.7年 (16-49岁人群8.3年).
- 由于超重而导致的潜在质量调整寿命年 (QALY) 损失估计为每年24亿英,或每人522英.
- 在英格兰的ICB中观察到肥胖患病率,过度死亡率和HCRU的显著地理差异.
结论:
- 肥胖个体的死亡率增加部分抵消了终身医疗费用,这表明短期的HCRU减少不足以资助干预措施.
- 与肥胖相关的HCRU的累积性质需要长期战略,潜在的QALY收益支持密集的体重管理计划.
- 对致病性肥胖个体的有针对性的干预可以产生显著的QALY价值,估计每人每年2864英.
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