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. 2015 Apr 1;10(4):e0121160.
doi: 10.1371/journal.pone.0121160. eCollection 2015.

Direct healthcare cost of obesity in brazil: an application of the cost-of-illness method from the perspective of the public health system in 2011

Michele Lessa de Oliveira  1 , Leonor Maria Pacheco Santos  1 , Everton Nunes da Silva  1
Affiliations

Direct healthcare cost of obesity in brazil: an application of the cost-of-illness method from the perspective of the public health system in 2011

Michele Lessa de Oliveira et al. PLoS One. .

Abstract

Background: Obesity is a global public health problem and a risk factor for several diseases that financially impact healthcare systems.

Objective: To estimate the direct costs attributable to obesity (body mass index {BMI} ≥ 30 kg/m2) and morbid obesity (BMI ≥ 40 kg/m2) in adults aged ≥ 20 incurred by the Brazilian public health system in 2011.

Settings: Public hospitals and outpatient care.

Methods: A cost-of-illness method was adopted using a top-down approach based on prevalence. The proportion of the cost of each obesity-associated comorbidity was calculated and obesity prevalence was used to calculate attributable risk. Direct healthcare cost data (inpatient care, bariatric surgery, outpatient care, medications and diagnostic procedures) were extracted from the Ministry of Health information systems, available on the web.

Results: Direct costs attributable to obesity totaled US$ 269.6 million (1.86% of all expenditures on medium- and high-complexity health care). The cost of morbid obesity accounted for 23.8% (US$ 64.2 million) of all obesity-related costs despite being 18 times less prevalent than obesity. Bariatric surgery costs in Brazil totaled US$ 17.4 million in 2011. The cost of morbid obesity in women was five times higher than it was in men.

Conclusion: The cost of morbid obesity was found to be proportionally higher than the cost of obesity. If the current epidemic were not reversed, the prevalence of obesity in Brazil will increase gradually in the coming years, as well as its costs, having serious implications for the financial sustainability of the Brazilian public health system.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. RR or OR for diseases associated with obesity (BMI ≥ 30 kg/m2) and morbid obesity (BMI ≥ 40 kg/m2) in adults aged 20 and over, according to sex.
Sources: 6WHO 2012, 9Guh, 2009, 10IASO (1) (*), 11Martinez, 2004, 12Mokdad et al, 2001, 13Renehan et al, 2008 (1), 14Yang, 2009. (1) RR calculated for the mean BMI of morbidly obese adults (BMI = 43.42 kg/m2) (*) In this study confidence interval for the RR were not calculated (**) outliers
Fig 2
Fig 2. Proportion of costs attributable to morbid obesity (BMI ≥ 40 kg/m2) in relation to the total costs of obesity (BMI ≥ 30 kg/m2) for each pathology analyzed, Brazil, 2011.
See this image and copyright information in PMC

References

    1. Finucane MM, Stevens GA, Cowan MJ, Danaei G, Lin JK, Paciorek CJ, et al. National, regional, and global trends in body-mass index since 1980: systematic analysis of health examination surveys and epidemiological studies with 960 country-years and 9·1 million participants. Lancet. 2011;377(9765):557–67. 10.1016/S0140-6736(10)62037-5 . - DOI - PMC - PubMed
    1. Finkelstein EA, Fiebelkorn IC, Wang G. National medical spending attributable to overweight and obesity: how much, and who's paying? Health Aff (Millwood). 2003;Suppl Web Exclusives:W3-219-26. . - PubMed
    1. World Health Organization. Global Health Observatory 2012 [Internet]. [cited 2012 June 21]. Available: http://www.who.int/gho/ncd/risk_%20factors/obesity_text/en/.
    1. Brasil. Instituto Brasileiro de Geografia e Estatística. Pesquisa de orçamentos familiares 2008–2009: antropometria e estado nutricional de crianças, adolescentes e adultos no Brasil Rio de Janeiro: IBGE; 2010. p. 130.
    1. Santos LM, de Oliveira IV, Peters LR, Conde WL. Trends in morbid obesity and in bariatric surgeries covered by the Brazilian public health system. Obes Surg. 2010;20(7):943–8. 10.1007/s11695-008-9570-3 . - DOI - PubMed