The direct and indirect costs of both overweight and obesity: a systematic review

BMC Research Notes

Ivan J Perry²  Sarah Fitzgerald²  Victoria O’Dwyer²  Anthony Staines¹  Linda Sharp³  Ciaran O’Neill⁴  Karen Kearns²  Anne Dee⁵ 

[1] School of Nursing and Human Sciences, Dublin City University, Dublin 9, Ireland;Department of Epidemiology and Public Health, Western Gate Building, University College Cork, Cork, Ireland;National Cancer Registry Ireland, Building 6800, Cork Airport Business Park, Kinsale Road, Cork, Ireland;J.E. Cairns School of Business and Economics, National University of Ireland, Galway, Ireland;Department of Public Health, Health Service Executive West, Mount Kennett House, Henry Street, Limerick, Ireland

关键词: Obesity;    Overweight;    Lost productivity costs;    Indirect costs;    Health care costs;    Direct costs;   

Others  :  1133435
DOI  :  10.1186/1756-0500-7-242

 received in 2014-03-12, accepted in 2014-04-10,  发布年份 2014

【 摘 要 】

Background

The rising prevalence of overweight and obesity places a financial burden on health services and on the wider economy. Health service and societal costs of overweight and obesity are typically estimated by top-down approaches which derive population attributable fractions for a range of conditions associated with increased body fat or bottom-up methods based on analyses of cross-sectional or longitudinal datasets. The evidence base of cost of obesity studies is continually expanding, however, the scope of these studies varies widely and a lack of standardised methods limits comparisons nationally and internationally. The objective of this review is to contribute to this knowledge pool by examining direct costs and indirect (lost productivity) costs of both overweight and obesity to provide comparable estimates. This review was undertaken as part of the introductory work for the Irish cost of overweight and obesity study and examines inconsistencies in the methodologies of cost of overweight and obesity studies. Studies which evaluated the direct costs and indirect costs of both overweight and obesity were included.

Methods

A computerised search of English language studies addressing direct and indirect costs of overweight and obesity in adults between 2001 and 2011 was conducted. Reference lists of reports, articles and earlier reviews were scanned to identify additional studies.

Results

Five published articles were deemed eligible for inclusion. Despite the limited scope of this review there was considerable heterogeneity in methodological approaches and findings. In the four studies which presented separate estimates for direct and indirect costs of overweight and obesity, the indirect costs were higher, accounting for between 54% and 59% of the estimated total costs.

Conclusion

A gradient exists between increasing BMI and direct healthcare costs and indirect costs due to reduced productivity and early premature mortality. Determining precise estimates for the increases is mired by the large presence of heterogeneity among the available cost estimation literature. To improve the availability of quality evidence an international consensus on standardised methods for cost of obesity studies is warranted. Analyses of nationally representative cross-sectional datasets augmented by data from primary care are likely to provide the best data for international comparisons.

【 授权许可】

   
2014 Dee et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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