The household economic burden of eating disorders and adherence to treatment in Australia

Abstract

BackgroundThis study investigated the household economic burden of eating disorders and cost-related non-adherence to treatment in Australia.MethodsMulti-centre prospective observational study using a structured questionnaire. Ninety participants were recruited from two clinic settings in New South Wales, Australia and from the community using social media. The primary outcome measures were household economic burden of illness measured in terms of out-of-pocket expenditure, household economic hardship and cost-related non-adherence.ResultsThe pattern of out-of-pocket expenditure varied by diagnosis, with Bulimia Nervosa associated with the highest total mean expenditure (per three months). Economic hardship was reported in 96.7% of participants and 17.8% reported cost-related non-adherence. Those most likely to report cost-related non-adherence had a longer time since diagnosis. Cost-related non-adherence and higher out-of-pocket expenditure were associated with poorer quality of life, a more threatening perception of the impact of the illness and poor self-reported health.ConclusionsThis study is the first to empirically and quantitatively examine the household economic burden of eating disorders from the patient perspective. Results indicate that households experience a substantial burden associated with the treatment and management of an eating disorder. This burden may contribute to maintaining the illness for those who experience cost-related non-adherence and by negatively influencing health outcomes. Current initiatives to implement sustainable and integrated models of care for eating disorders should strive to minimise the economic impact of treatment on families.Electronic supplementary materialThe online version of this article (doi:10.1186/s12888-014-0338-0) contains supplementary material, which is available to authorized users.

Perceived barriers and facilitators towards help‐seeking for eating disorders: A systematic review

“…Eating disorders are severe and often chronic mental disorders that are associated with impaired cognitive and emotional functioning, restricted quality of life, lifelong physical and psychosocial morbidity, psychiatric comorbidity, and increased risk of mortality . In addition to the substantial individual and personal burden associated with eating disorders, the financial and economic impact of these illnesses is enormous . Although health care utilization among these individuals is elevated and evidence‐based treatments for eating disorders exist, a systematic review undertaken by Hart et al concluded that the pooled proportion of participants seeking treatment was 23.2% (95% CI = 16.6, 31.4).…”

“…3 In addition to the substantial individual and personal burden associated with eating disorders, the financial and economic impact of these illnesses is enormous. 4,5 Although health care utilization among these individuals is elevated 6 and evidence-based treatments for eating disorders exist, 7-10 a systematic review undertaken by Hart et al 11 concluded that the pooled proportion of participants seeking treatment was 23.2% (95% CI 5 16.6, 31.4). However, variability in figures was reported in the review with proportions of participants seeking eating disorder treatment ranging from 0% in a study among middle school females 12 to 52% in a study among adult females with binge eating disorders.…”

Clinical and financial implications of hospital malnutrition in Spain

“…One study from Australia investigated the household economic burden of eating disorders and cost-related nonadherence to treatment (Gatt et al, 2014). The primary outcome was the household economic burden of eating disorders measured using the following: out-ofpocket expenditure on medical and health-related expenses, household economic hardship (hardship hereafter), and cost-related non-adherence.…”

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“…9 It was estimated that 914,000 people in Australia suffered from eating disorders in 2012. 10 The corresponding cost, including caring for the people suffering, was approximately $69 billion. 11 Different cultures and races have different definitions of beauty.…”