The Economic Cost of Overweight and Obesity in Ireland. Dr. Anne Dee 17/01/2014

Transcription

1 The Economic Cost of Overweight and Obesity in Ireland Dr. Anne Dee 17/01/2014

2 Acknowledgements UCC Professor Ivan Perry, Dr. Anne Dee, Karen Kearns NUIG Professor Ciaran O Neill, Dr. Edel Doherty, Dr. Aoife Callan DCU Professor Anthony Staines, Dr. Treasa McVeigh, Dr. Mary Rose Sweeney QUB - Professor Frank Kee National Cancer Registry - Dr. Linda Sharp Institute of Public Health - Professor Kevin Balanda Safefood- Dr Cliodhna Foley Nolan

3 Used with permission Used with permission

4 Prevalence of Overweight and Obesity

5 Percentage increased risk for overweight and obese females-cancers 250% 222% 200% 150% 164% 100% 50% 0% 8% 13% Breast Post menopausal 45% 66% 53% 15% 20% Large Bowel Uterus Oesophagus Kidney Pancreas Gall bladder 82% 24% 60% 35% Female Overweight Female obese Source Guh et al 2009, WCRF %

6 Percentage increased risk for overweight and obese males-cancers 140% 129% 120% 100% 80% 95% 82% 60% 40% 20% 0% 51% 40% 28% 21% 25% 13% 5% Large Bowel Oesophagus Kidney Pancreas Gall bladder Male Overweight Male Obese Source Guh et al 2009, WCRF 2007

7 % increased risk Percentage risk increase for chronic diseases- Males 350% 300% 250% 200% 150% 100% 50% 0% % 181% 176% 59% 72% 84% 51% 29% 23% 28% 144% 70% 43% 43% 9% 20% % 87% Overweight male Obese male Chronic back pain Osteoarthritis Coronary Artery Disease Stroke Hypertension DVT Gallbladder Disease Asthma Gout Disease Source Guh et al 2009, Bhole et al 2010

8 % increased risk Percentage increased risk of chronic diseases-females 300% 250% 200% 150% 100% 50% 181% 59% % 96% 80% 80% 49% 15% 142% 144% 65% 70% 132% 44% 78% 25% % 67% Overweight female Obese female 0% Chronic back pain Osteoarthritis Coronary Artery Disease Stroke Hypertension DVT Gallbladder Disease Asthma Gout Disease Source Guh et al 2009, Bhole et al 2010

9 Type II diabetes in overweight & obesity in males & females 1200% 1141% 1000% 800% 600% 574% 400% 292% 200% 140% 0% Male overweight Male obese Female overweight Female obese Source Guh et al 2009

10 Literature review Overweight and obesity account for somewhere between 1% and 9% of total healthcare costs Non-healthcare costs may be as much again or even more. Studies show them to comprise 51% to 84% of total costs Costs increase with increasing BMI

11 Methods- Included costs Healthcare costs include: In-Patient Out-patient General Practice Drugs and prescribing costs Non-healthcare costs include lost productivity due to: Time off work due to overweight and obesity related illness Premature mortality

12 Methods for the study Mixed :Top down supplemented by Bottom up

13 Methods: Top-down Prevalence based approach Large cost datasets Calculate Population Attributable Fractions (PAF) using Relative Risks and Prevalence rates for overweight and obesity Apply PAF to cost data PAFs calculated by age and gender

14 Methods: Bottom-up Cross Sectional individual level data Probability of using service Additional probability of using service if increased BMI Controlled for confounders

15 Methods: Healthcare costs data sources SLÁN, TILDA and NIHS 2010/11 to map healthcare usage by BMI HIPE and HIS data Drugs and prescribing using PCRS and BSO data

16 Non-Healthcare costs data sources Illness Benefit Data-both jurisdictions Limited data available relating medical conditions to illness benefit payments Also some information available from SLAN CSO data on premature mortality

17 Republic of Ireland Republic of Ireland Range Range Cost Direct costs GP (Cross-sectional analyses) 15,700,000 30,000,000 In-patient/day case (Cross-sectional analyses) 7,100,000 91,100,000 In-patient/day case (PAF method) 125,686, ,025,571 22,900,000 45,910, ,849,916 Out-patient (Cross-sectional analyses) (significant at 90% level) 0-14,855,791 6,890,000 Drugs (PAF method) 156,294, ,589, ,441,904 Indirect costs Absenteeism (Cross-sectional analyses) Human capital approach Absenteeism (Cross-sectional analyses) Friction cost approach Absenteeism (PAF method) Human capital approach Absenteeism (PAF method) Friction cost approach 11,291, ,385,875 5,497, ,215, ,106, ,115,974 54,904,907-87,400, ,667,747 71,715, ,977,068 72,133,090 Premature mortality (PAF method) 420,200, ,500, ,991,594

18 Northern Ireland Range PPP Cost PPP Direct costs GP (Cross-sectional analyses) 0-15,210,484 7,411,564 In-patient/Day-case (Cross-sectional analyses) 31,187, ,410,785 82,299,148 In-patient/Day-case (PAF method) 28,613,870-57,227,740 Out-patient (Cross-sectional analyses) Drugs (PAF method) 51,382, ,765,696 Indirect costs Absenteeism (Cross-sectional analyses) 42,920,805 No significant difference detected 77,074,272 No significant difference detected Absenteeism (PAF method) Human capital approach Absenteeism (PAF method) Friction cost approach 215,000, ,000,000 74,400,000-88,600, ,500,000 81,500,000 Premature mortality (PAF method) 107,022, ,486, ,417,113

19 Results Republic of Ireland Northern Ireland (PPP Irish 2009 ) Direct costs 437,081, ,406,641 Indirect costs 728,968, ,917,113 Total costs 1,166,050, ,323,754

20 Results In ROI the direct costs represent 38% of total costs and 2.9% of healthcare spending. In NI the direct costs were 25% of total costs and 2.8% of healthcare spending.

21 Main contributing conditions to Direct Healthcare Costs Cardiovascular disease Type II Diabetes Colon Cancer Stroke Gallbladder Disease

22 Absenteeism ROI Chronic back pain 57% Osteoarthritis 18% Coronary Artery Disease 9% Hypertension 6% Diabetes 4% Stroke 1%

23 Premature Mortality Main drivers of cost were Cardiovascular Disease (inc Stroke) Colorectal cancer Diabetes Type II

24 Main Recommendations Urgent Public Health action required A Population Health wide prevention approach Targeted action for the very obese is required Workplace interventions is needed Extend regulation of the food industry Significant investment in research

25 Full list of recommendations Available at: odlibrary/documents/publications/research%2 0Reports/Final-Exec-Summary-The-Economic- Cost-of-Obesity.pdf

26 Questions/ Comments?