Abstract
Objective: The aim of this paper is to highlight the potential impact of costs associated with overweight and obesity for provincial policy and prevention initiatives.
Method: Prevalence-based cost-of-illness methodology was used to estimate the direct costs (hospital care, drugs, physician care, institutional care, additional costs) and indirect costs (short- and long-term disability, premature mortality) associated with excess weight for 22 health conditions. Total costs for each health condition were estimated using the Public Health Agency of Canada’s Economic Burden of Illness database. Population attributable fractions (PAF) were also estimated using 2004 and 2005 CCHS data and current literature reviews.
Results: In 2005, the cost of excess weight in Alberta totaled $1.27 billion. The direct cost of excess weight was $630.1M (49.5%), the indirect cost $643.8M (50.5%). Excluding costs associated with premature mortality and caregiving, obesity accounted for 69.5% ($500.8M) of costs and overweight the remaining 30.5% ($220.2M). Among the 22 health conditions, coronary heart disease had the highest costs attributable to excess weight ($307.1M), followed by osteoarthritis ($167.7M) and type 2 diabetes ($161.5M). The total cost of excess weight equated to 5.6% of the province’s annual health care expenditures for 2005.
Conclusion: While obesity costing research often focuses on the direct health care costs, this study reveals that the indirect costs of excess weight are also significant and can account for over half of the total costs. Interventions to reduce excess weight among Canadians have the potential to improve the health of the population while reducing provincial and national health care costs.
Key Words: Obesity, overweight, Canada; cost, cost of illness
Résumé
Objectif: Souligner l’impact possible des coûts associés au surpoids et à l’obésité sur les politiques et les initiatives de prévention de la province de l’Alberta.
Méthode: Par une méthode de calcul du coût de la maladie basé sur la prévalence, nous avons estimé les coûts directs (soins hospitaliers, médicaments, soins médicaux, soins en établissement, coûts supplémentaires) et indirects (incapacité de courte et de longue durée, mortalité prématurée) associés à l’excès de poids pour 22 affections médicales. Les coûts totaux de chaque affection ont été estimés à l’aide de la base de données de l’Agence de la santé publique du Canada sur le fardeau économique de la maladie au Canada. Nous avons aussi estimé les fractions attribuables dans la population (FAP) à l’aide des données de 2004 et de 2005 de l’Enquête sur la santé dans les collectivités canadiennes et d’analyses documentaires récentes.
Résultats: En 2005, le coût de l’excès de poids en Alberta s’est élevé à 1,27 milliard de dollars. Son coût direct était de 630,1 M$ (49,5 %) et son coût indirect, de 643,8 M$ (50,5 %). Exception faite des coûts associés à la mortalité prématurée et à la prestation des soins, l’obésité représentait 69,5 % des coûts (500,8 M$), et le surpoids, les 30,5 % restants (220,2 M$). Sur les 22 affections médicales, la maladie coronarienne présentait les coûts imputables à l’excès de poids les plus élevés (307,1 M$), suivie de l’arthrose (167,7 M$) et du diabète de type II (161,5 M$). Le coût total de l’excès de poids correspondait à 5,6 % des dépenses annuelles en soins de santé de la province pour 2005.
Conclusion: Les recherches sur le calcul des coûts de l’obésité s’attachent souvent aux coûts directs des soins de santé, mais notre étude montre que les coûts indirects de l’excès de poids sont tout aussi considérables et peuvent représenter plus de la moitié des coûts totaux. Les interventions visant à réduire l’excès de poids chez les Canadiens pourraient donc améliorer la santé de la population tout en réduisant les coûts provinciaux et nationaux des soins de santé.
Mots Clés: obésité, surpoids, le Canada, coûts, coût de la maladie
Footnotes
Acknowledgements: The Cost of Obesity in Alberta Report was produced by Ronald Colman and Karen Hayward, Genuine Progress Index (GPI) Atlantic Canada Incorporated. The report was made possible through Alberta Health Services, Health Promotion, Disease and Injury Prevention. The authors acknowledge Monica Schwann, Corinne Parker, Lisa Petermann, Jennifer Dotchin, Tony Mottershead, Kerry Coupland and Geraldine Lo Siou for their assistance with the project. Funding for this project was supported by Alberta Health Services, as well as the Canadian Partnership Against Cancer.
Conflict of Interest: None to declare.
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