The costs of overweight and obesity-related diseases in the Brazilian public health system: cross-sectional study

Abstract

BackgroundObesity is a major global epidemic and a burden to society and health systems. It is well known risk factor for a number of chronic medical conditions with high morbidity and mortality. This study aimed to provide an estimate of the direct costs associated to outpatient and inpatient care of overweight and obesity related diseases in the perspective of the Brazilian Health System (SUS).MethodsPopulation attributable risk (PAR) was calculated for selected diseases related to overweight and obesity and with the following parameters: Relative risk (RR) ≥ 1.20 or RR ≥1.10 and < 1.20, but important problem of public health due its high prevalence. After a broad search in the literature, two meta-analysis were selected to provide RR for PAR calculation. The prevalence rates of overweight and obesity in Brazilians with ≥18 years were obtained from large national survey. The national health database (DATASUS) was used to estimate the annual cost of the Brazilian Unified Health System (SUS) with the diseases included in the analysis. The extracted values were stratified by sex, type of service (inpatient or outpatient care) and year. Data were collected from 2008 to 2010 and the results reflect the average of 3 years. Brazilian costs were converted into US dollars during the analysis using a purchasing power parity basis (2010).ResultsThe estimated total costs in one year with all diseases related to overweight and obesity are US$ 2,1 billion; US$ 1,4 billion (68.4% of total costs) due to hospitalizations and US$ 679 million due to ambulatory procedures. Approximately 10% of these cost is attributable to overweight and obesity.ConclusionThe results confirm that overweight and obesity carry a great economic burden for Brazilian health system and for the society. The knowledge of these costs will be useful for future economic analysis of preventive and treatment interventions.

Neck circumference as a complementary measure to identify excess body weight in children aged 13-24 months

“…Amongst children aged 5-9 years, the rate of childhood obesity has risen from 2.4% in 1975 to 14.2% in 2009, 3 generating a great economic burden for the Brazilian Health System. 4 A more rapid increase in weight-for-length during the first six months of life has been shown to be significantly associated with an increased risk of obesity at three years of age. 5 Furthermore, weight alterations during infancy may have a greater influence on later risk of obesity than birth weight.…”

Influência do excesso de peso e da obesidade nos gastos em saúde nos domicílios brasileiros

“…A presença e o aumento do número de indivíduos com excesso de peso e obesidade, com maior magnitude para este último, resultaram em maior dispêndio total em saúde, com destaque para os gastos com medicamentos e planos de saúde, mesmo após ajuste para as variáveis de confusão associadas aos gastos e ao estado nutricional dos 5,6 , em estudos de gasto privado em saúde não é comum analisar o sobrepeso ou o excesso de peso (sobrepeso + obesidade). Assim, destaca-se, neste estudo, o fato de o sobrepeso ter sido analisado na categoria de "domicílios com indivíduos com excesso de peso".…”

“…Além disso, famílias com indivíduos com doenças crô-nicas foram 2,6 vezes mais propensas a gastar mais que US$ 1.000 anuais com assistência mé-dica 34 . Esses achados são relevantes na medida em que a obesidade está associada à ocorrência de diversas doenças crônicas 5,6,7 .…”

“…Dados do último inquérito que avaliou o estado nutricional da população brasileira indicam que a prevalência de obesidade entre crianças, adolescentes e indivíduos maiores de 20 anos é de, respectivamente, 14,3%, 4,9% e 14,8% 3 . Como consequência, a obesidade resulta em elevado custo para diversos países, principalmente aqueles desenvolvidos 4 , e no Brasil já se conhece a magnitude do impacto do sobrepeso e da obesidade para o sistema público de saúde, o Sistema Único de Saúde (SUS) 5,6,7 .…”

“…A obesidade também está relacionada a alguns desses fatores 20,21,22 e, uma vez que esta tem impacto financeiro sobre o SUS 5,6,7 , pode também resultar em maiores gastos em saúde para as famílias.…”