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Prävention und Therapie von Übergewicht und Adipositas im Kindes- und Jugendalter aus gesundheitsökonomischer Sicht

Economic aspects of prevention and treatment of overweight and obesity in children and adolescents

  • Leitthema
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Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz Aims and scope

Zusammenfassung

Der vorliegende Beitrag gibt einen Überblick über die Kosten von Übergewicht und Adipositas im Kindes- und Jugendalter und über die Kosteneffektivität präventiver und therapeutischer Gesundheitsleistungen. Zunächst werden die Ergebnisse von Krankheitskostenstudien aus der internationalen Literatur vorgestellt. Diese präsentieren kein einheitliches Bild, deuten jedoch an, dass Adipositas bereits im Kindes- und Jugendalter mit moderaten zusätzlichen Versorgungskosten einhergeht. Anschließend wird aufgezeigt, wie mit den Methoden der ökonomischen Evaluation die Kosteneffektivität präventiver und therapeutischer Gesundheitsleistungen beurteilt werden kann. Probleme ergeben sich dabei aus der Notwendigkeit der Schätzung langfristiger Auswirkungen auf die Kosten und Effekte einer Vielzahl assoziierter Folgekrankheiten. In der internationalen Literatur vorgestellte ökonomische Evaluationsstudien weisen auf die Kosteneffektivität verschiedener präventiver und therapeutischer Gesundheitsleistungen hin. Zur Steigerung der Wirtschaftlichkeit der Gesundheitsversorgung sollten vermehrt kosteneffektive Maßnahmen zur Prävention und Therapie von Übergewicht und Adipositas entwickelt und eingesetzt werden.

Abstract

This article provides an overview of the costs associated with overweight and obesity in children and adolescents, and of the cost effectiveness of preventive and therapeutic interventions. First, the results of cost-of-illness studies from the international literature are presented. These studies show ambiguous results, but indicate moderate excess costs due to obesity for this age group. Subsequently, this paper describes the methods that can be used to analyze the cost effectiveness of preventive and therapeutic interventions. Problems arise from the necessity to estimate long-term effects on costs and health consequences of multiple, associated diseases. A number of economic evaluations of preventive and therapeutic interventions published in the scientific literature have reported favorable cost effectiveness. In order to increase the efficiency of health care, more cost-effective services for overweight and obesity should be developed and used.

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Literatur

  1. WHO (2000) Obesity: preventing and managing the global epidemic. Report of a WHO consultation. World Health Organ Tech Rep Ser 894:i–xii, 1–253

    Google Scholar 

  2. Wang Y, Lobstein T (2006) Worldwide trends in childhood overweight and obesity. Int J Pediatr Obes 1:11–25

    Article  PubMed  Google Scholar 

  3. Kurth BM, Schaffrath Rosario A (2010) Overweight and obesity in children and adolescents in Germany. Bundesgesundheitsbl Gesundheitsforsch Gesundheitsschutz 53:643–652

    Article  Google Scholar 

  4. Wabitsch M (2004) Obese children and adolescents in Germany. A call for action. Bundesgesundheitsbl Gesundheitsforsch Gesundheitsschutz 47:251–255

    Article  CAS  Google Scholar 

  5. Singh AS, Mulder C, Twisk JW et al (2008) Tracking of childhood overweight into adulthood: a systematic review of the literature. Obes Rev 9:474–488

    Article  PubMed  CAS  Google Scholar 

  6. Must A, Jacques PF, Dallal GE et al (1992) Long-term morbidity and mortality of overweight adolescents. A follow-up of the Harvard Growth Study of 1922 to 1935. N Engl J Med 327:1350–1355

    Article  PubMed  CAS  Google Scholar 

  7. John J, Wenig CM, Wolfenstetter SB (2010) Recent economic findings on childhood obesity: cost-of-illness and cost-effectiveness of interventions. Curr Opin Clin Nutr Metab Care 13:305–313

    Article  PubMed  Google Scholar 

  8. Daviglus ML, Liu K, Yan LL et al (2004) Relation of body mass index in young adulthood and middle age to Medicare expenditures in older age. JAMA 292:2743–2749

    Article  PubMed  CAS  Google Scholar 

  9. Buescher PA, Whitmire JT, Plescia M (2008) Relationship between body mass index and medical care expenditures for North Carolina adolescents enrolled in Medicaid in 2004. Prev Chronic Dis 5:A04

    PubMed  Google Scholar 

  10. Woolford SJ, Gebremariam A, Clark SJ, Davis MM (2007) Incremental hospital charges associated with obesity as a secondary diagnosis in children. Obesity 15:1895–1901

    Article  PubMed  Google Scholar 

  11. Trasande L, Chatterjee S (2009) The impact of obesity on health service utilization and costs in childhood. Obesity (Silver Spring) 17:1749–1754

    Google Scholar 

  12. Trasande L, Liu YH, Fryer G, Weitzman M (2009) Effects of childhood obesity on hospital care and costs, 1999–2005. Health Affairs 28:W751–W760

    Article  PubMed  Google Scholar 

  13. Skinner AC, Mayer ML, Flower K, Weinberger M (2008) Health status and health care expenditures in a nationally representative sample: How do overweight and healthy-weight children compare? Pediatrics 121:e269–e277

    Article  PubMed  Google Scholar 

  14. Vellinga A, O’Donovan D, De La Harpe D (2008) Length of stay and associated costs of obesity related hospital admissions in Ireland. BMC Health Serv Res 8:88

    Article  PubMed  Google Scholar 

  15. Wang G, Dietz WH (2002) Economic burden of obesity in youths aged 6 to 17 years: 1979–1999. Pediatrics 109:E81–E81

    Article  PubMed  Google Scholar 

  16. Estabrooks PA, Shetterly S (2007) The prevalence and health care use of overweight children in an integrated health care system. Arch Pediatr Adolesc Med 161:222–227

    Article  PubMed  Google Scholar 

  17. Janicke DM, Harman JS, Jamoom EW et al (2010) The relationship among child weight status, psychosocial functioning, and pediatric health care expenditures in a medicaid population. J Pediatr Psychol 35:883–891

    Article  PubMed  Google Scholar 

  18. Hering E, Pritsker I, Gonchar L, Pillar G (2009) Obesity in children is associated with increased health care use. Clin Pediatr 48:812–818

    Article  Google Scholar 

  19. Wolfenstetter SB (2006) Juvenile obesity and comorbidity type 2 diabetes mellitus (T2 DM) in Germany: development and cost-of-illness analysis. Gesundheitswesen 68:600–612

    Article  PubMed  CAS  Google Scholar 

  20. Johnson E, McInnes MM, Shinogle JA (2006) What is the economic cost of overweight children? East Econ J 32:171–187

    Google Scholar 

  21. Hampl SE, Carroll CA, Simon SD, Sharma V (2007) Resource utilization and expenditures for overweight and obese children. Arch Pediatr Adolesc Med 161:11–14

    Article  PubMed  Google Scholar 

  22. Finkelstein EA, Trogdon JG (2008) Public health interventions for addressing childhood overweight: analysis of the business case. Am J Public Health 98:411–415

    Article  PubMed  Google Scholar 

  23. Monheit AC, Vistnes JP, Rogowski JA (2009) Overweight in adolescents: implications for health expenditures. Econ Hum Biol 7:55–63

    Article  PubMed  Google Scholar 

  24. Bell JF, Zimmerman FJ, Arterburn DE, Maciejewski ML (2011) Health-care expenditures of overweight and obese males and females in the medical expenditures panel survey by age cohort. Obesity (Silver Spring) 1:228–232

    Google Scholar 

  25. Konnopka A, Bodemann M, Konig HH (2010) Health burden and costs of obesity and overweight in Germany. Eur J Health Econ [Epub 2010 Apr 18]

  26. Muller-Riemenschneider F, Reinhold T, Berghofer A, Willich SN (2008) Health-economic burden of obesity in Europe. Eur J Epidemiol 23:499–509

    Article  PubMed  Google Scholar 

  27. Lengerke T von, Reitmeir P, John J (2006) Direct medical costs of (severe) obesity: a bottom-up assessment of over- vs. normal-weight adults in the KORA-study region (Augsburg, Germany). Gesundheitswesen 68:110–115

    Article  Google Scholar 

  28. Barkin SL, Heerman WJ, Warren MD, Rennhoff C (2010) Millennials and the world of work: the impact of obesity on health and productivity. J Bus Psychol 25:239–245

    Article  PubMed  Google Scholar 

  29. Jia H, Lubetkin EI (2010) Obesity-related quality-adjusted life years lost in the U.S. from 1993 to 2008. Am J Prev Med 39:220–227

    Article  PubMed  Google Scholar 

  30. Trogdon JG, Finkelstein EA, Hylands T et al (2008) Indirect costs of obesity: a review of the current literature. Obes Rev 9:489–500

    Article  PubMed  CAS  Google Scholar 

  31. Gold M, Siegel J, Russell L, Weinstein M (1996) Cost-effectiveness in health and medicine. Oxford University Press, New York

  32. Murray CJ (1994) Quantifying the burden of disease: the technical basis for disability-adjusted life years. Bull World Health Organ 72:429–445

    PubMed  CAS  Google Scholar 

  33. Haddix AC, Teusch SM, Phaedra SC (2003) Prevention effectiveness. Oxford University Press, Oxford

  34. Becker C, Leidl R, Stollenwerk B (2010) Entscheidungsanalytische Modellierung in der ökonomischen Evaluation [Decision-Analytic Modelling in Economic Evaluation]. Gesundh Ökon Qual Manag 15:260–264

    Article  Google Scholar 

  35. Bond M, Wyatt K, Lloyd J et al (2009) Systematic review of the effectiveness and cost-effectiveness of weight management schemes for the under fives: a short report. Health Technol Assess 13:1–75

    Google Scholar 

  36. McAuley KA, Taylor RW, Farmer VL et al (2010) Economic evaluation of a community-based obesity prevention program in children: the APPLE project. Obesity (Silver Spring) 18:131–136

  37. Wang LY, Gutin B, Barbeau P et al (2008) Cost-effectiveness of a school-based obesity prevention program. J Sch Health 78:619–624

    Article  PubMed  Google Scholar 

  38. Moodie ML, Carter RC, Swinburn BA, Haby MM (2010) The cost-effectiveness of Australia’s Active After-School Communities program. Obesity (Silver Spring) 18:1585–1592

    Google Scholar 

  39. Magnus A, Haby MM, Carter R, Swinburn B (2009) The cost-effectiveness of removing television advertising of high-fat and/or high-sugar food and beverages to Australian children. Int J Obes (Lond) 33:1094–1102

    Google Scholar 

  40. Moodie M, Haby M, Galvin L et al (2009) Cost-effectiveness of active transport for primary school children – Walking School Bus program. Int J Behav Nutr Phys Act 6:63

    Article  PubMed  Google Scholar 

  41. Wang LY, Yang Q, Lowry R, Wechsler H (2003) Economic analysis of a school-based obesity prevention program. Obes Res 11:1313–1324

    Article  PubMed  Google Scholar 

  42. Brown HS, Perez A, Li YP et al (2007) The cost-effectiveness of a school-based overweight program. Int J Behav Nutr Phys Act 4:47

    Article  PubMed  Google Scholar 

  43. Kalavainen M, Karjalainen S, Martikainen J et al (2009) Cost-effectiveness of routine and group programs for treatment of obese children. Pediatr Int 51:606–611

    Article  PubMed  Google Scholar 

  44. Goldfield GS, Epstein LH, Kilanowski CK et al (2001) Cost-effectiveness of group and mixed family-based treatment for childhood obesity. Int J Obes 25:1843–1849

    Article  CAS  Google Scholar 

  45. Wake M, Baur LA, Gerner B et al (2009) Outcomes and costs of primary care surveillance and intervention for overweight or obese children: the LEAP 2 randomised controlled trial. Br Med J 339:b3308

    Article  Google Scholar 

  46. Wake M, Gold L, McCallum Z et al (2008) Economic evaluation of a primary care trial to reduce weight gain in overweight/obese children: The LEAP trial. Ambul Pediatr 8:336–341

    Article  PubMed  Google Scholar 

  47. Janicke DM, Sallinen BJ, Perri MG et al (2009) Comparison of program costs for parent-only and family-based interventions for pediatric obesity in medically underserved rural settings. J Rural Health 25:326–330

    Article  PubMed  Google Scholar 

  48. Ananthapavan J, Moodie M, Haby M, Carter R (2010) Assessing cost-effectiveness in obesity: laparoscopic adjustable gastric banding for severely obese adolescents. Surg Obes Relat Dis 6:377–385

    Article  PubMed  Google Scholar 

  49. Luttikhuis HO, Baur L, Jansen H et al (2009) Interventions for treating obesity in children. Cochrane Database Syst Rev 21(1):CD001872

    Google Scholar 

  50. Doak CM, Visscher TLS, Renders CM, Seidell JC (2006) The prevention of overweight and obesity in children and adolescents: a review of interventions and programmes. Obes Rev 7:111–136

    Article  PubMed  CAS  Google Scholar 

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Danksagung

Diese Arbeit wurde durch das Bundesministerium für Bildung und Forschung (BMBF), FKZ: 01EO1001 gefördert.

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Authors and Affiliations

  1. Institut für Medizinische Soziologie, Sozialmedizin und Gesundheitsökonomie (IMSG), Universitätsklinikum Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Deutschland

    H.-H. König M.P.H., T. Lehnert & A. Konnopka

  2. IFB AdipositasErkrankungen, Universitätsmedizin Leipzig, Leipzig, Deutschland

    H.-H. König M.P.H., T. Lehnert & S. Riedel-Heller

  3. Institut für Sozialmedizin, Arbeitsmedizin und Public Health, Universität Leipzig, Leipzig, Deutschland

    S. Riedel-Heller

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  1. H.-H. König M.P.H.
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  2. T. Lehnert
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  3. S. Riedel-Heller
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  4. A. Konnopka
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Correspondence to H.-H. König M.P.H..

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König, HH., Lehnert, T., Riedel-Heller, S. et al. Prävention und Therapie von Übergewicht und Adipositas im Kindes- und Jugendalter aus gesundheitsökonomischer Sicht. Bundesgesundheitsbl. 54, 611–620 (2011). https://doi.org/10.1007/s00103-011-1262-9

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  • DOI: https://doi.org/10.1007/s00103-011-1262-9

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