The costs of overweight and obesity-related diseases in the Brazilian public health system: cross-sectional study.
BACKGROUND
Obesity is a major global epidemic and a burden to society and health systems. It is well known risk factor for a number of chronic medical conditions with high morbidity and mortality. This study aimed to provide an estimate of the direct costs associated to outpatient and inpatient care of overweight and obesity related diseases in the perspective of the Brazilian Health System (SUS).


METHODS
Population attributable risk (PAR) was calculated for selected diseases related to overweight and obesity and with the following parameters: Relative risk (RR) ≥ 1.20 or RR ≥ 1.10 and < 1.20, but important problem of public health due its high prevalence. After a broad search in the literature, two meta-analysis were selected to provide RR for PAR calculation. The prevalence rates of overweight and obesity in Brazilians with ≥ 18 years were obtained from large national survey. The national health database (DATASUS) was used to estimate the annual cost of the Brazilian Unified Health System (SUS) with the diseases included in the analysis. The extracted values were stratified by sex, type of service (inpatient or outpatient care) and year. Data were collected from 2008 to 2010 and the results reflect the average of 3 years. Brazilian costs were converted into US dollars during the analysis using a purchasing power parity basis (2010).


RESULTS
The estimated total costs in one year with all diseases related to overweight and obesity are US$ 2,1 billion; US$ 1,4 billion (68.4% of total costs) due to hospitalizations and US$ 679 million due to ambulatory procedures. Approximately 10% of these cost is attributable to overweight and obesity.


CONCLUSIONS
The results confirm that overweight and obesity carry a great economic burden for Brazilian health system and for the society. The knowledge of these costs will be useful for future economic analysis of preventive and treatment interventions.
Internal Medicine Department, State University of Rio de Janeiro (UERJ) and National Institute of Science and Technology for Health Technology Assessment (IATS) - CNPq/Brazil, Blv, 28 de Setembro 77, Rio de Janeiro/RJ, Brazil. lucianabahia@gmail.com
Luciana
L
Bahia
Evandro Silva Freire
ES
Coutinho
Laura Augusta
LA
Barufaldi
Gabriela de Azevedo
Gde A
Abreu
Thainá Alves
TA
Malhão
Camila Pepe Ribeiro
CP
de Souza
Denizar Vianna
DV
Araujo
D000553:Ambulatory Care / Q000191:economics*; D001938:Brazil / Q000453:epidemiology; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D016208:Databases, Factual; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000191:economics*; D006801:Humans; D008297:Male; D015201:Meta-Analysis as Topic; D009765:Obesity / Q000150:complications / Q000191:economics*; D050177:Overweight / Q000150:complications / Q000191:economics*; D012306:Risk