Obezitenin Doğrudan ve Dolaylı Maliyetlerine İlişkin Bir Değerlendirme

Yıl 2020, Cilt: 12 Sayı: 2, 29 - 44, 15.06.2020

Ulvi Sandalcı Güner Tuncer

Öz

Öz

Obezite
birçok sağlık sorununa neden olan ve dünyada yaygın olarak görülen bir
hastalıktır. Obezite sağlık sorunları ile birlikte doğrudan ve dolaylı olmak
üzere ekonomik maliyetlere de neden olmaktadır. Obezitenin neden olduğu
doğrudan maliyetler tıbbi bakım ve tıbbi olmayan bakım maliyetlerinden
oluşmakta iken, dolaylı maliyetler işte varol(a)mama durumu, işe gelmeme,
engellilik ve erken ölüm maliyetlerinden oluşmaktadır. Obezite nedeniyle ortaya
çıkan bu maliyetler ülkelerin sağlık harcamaları içerisinde önemli boyutlara
ulaşmıştır.

Obezitenin
neden olduğu ekonomik maliyetleri incelediğimiz bu çalışmada dolaylı ve
doğrudan maliyetlerin önemli boyutlara ulaştığı ve ülkelerin sağlık harcama
kalemlerinde önemli miktarlarda artışa neden olduğuna ulaşılmıştır. Özellikle
obezitenin yaygın olduğu ülkelerde bu maliyetlerin daha yüksek miktarlarda
olduğu tespit edilmiştir. Türkiye’de de ekonomik maliyetlerin obezite
oranlarındaki artışa bağlı olarak önemli seviyelere ulaştığı ortaya çıkmıştır. Bununla
birlikte obezite ile etkin mücadele yapılmazsa hem Türkiye’de hem Dünya’da
obezite oranları ile birlikte ekonomik maliyetlerin de artan bir hızla
yükseleceği ve ülkelerin bütçeleri üzerinde daha büyük miktarlarda yük
getireceği tespiti yapılmıştır.

Anahtar Kelimeler

Obezite, Ekonomik Maliyet, Doğrudan Maliyet, Dolaylı Maliyet

Kaynakça

• Abdullah, A., Wolfe, R., Stoelwinder, J. U., De Courten, M., Stevenson, C., Walls, H. L., & Peeters, A. (2011). The number of yerars lived with Obesity and the Risk of All-Cause and Cause-Specific Mortality, International Journal of Epidemiology, 40 (4),985-996
• Adıyaman, F. (2015). Obezitenin Gazetelerde Sunumu (Yüksek Lisans Tezi, Anadolu Üniversitesi Sosyal Bilimler Enstitüsü, Eskişehir)Anis, A. H, Wei Z., Nick B., Daphne G., Z. Amarsi, & C L Birmingham, (2009). Obesity and overweight in Canada: an updated cost of illness study, Obesity Reviews, 11(1):31-40
• Andreyeva, T., Sturm R. & Jeanne S. R., (2004). Moderate and severe obesity have large differences in health care costs. Obesıty Research, Vol. 12 No. 12 December 2004
• Alavinia, S. M. & Burdorf, A. (2009). Productivity loss in the workforce: associations with health, work demands, and individual characteristics. American Journal of Industrial medicine, 2009;52:49–56.
• Arena, V. Krishna R. P. Wayne N. B. & Joseph J. S. (2006). The impact of body mass index on short-term disability in the workplace. Journal of Occupational Environmental Medicine, 2006; 48: 1118–1124.
• Arterburn, D. Maciejewski ML & Tsevat J., (2005). Impact of morbid obesity on medical expenditures in adults. International Journal of Obesity, (2005) 29, 334–339.
• Bergstrom, G., Lennart B., Jan H., Gunnar A. & Malin J. (2009). Sickness pre-senteeism today, sickness absenteeism tomorrow? A prospective study on sickness presenteeism and future sickness absenteeism. Journal Occup Environ Medicine, 2009;51:629–638.
• Birmingham, C. L., Jennifer L. M., Anita P., John J. S. & Aslam H. A. (1999). The cost of obesity in Canada. Canadian Medical Association Journal, 1999; 160: 483–488.
• Borg, S. Ulf P., Knut Ö., Göran B. Jan-Åke N. & Peter M. N. (2005). Obesity, survival, and hospital costs - findings from a screening project in Sweden. Value Health, 8(5):562–571.
• Brown, W. J., Richard H., Annette J. D. (2008). Physical activity, body mass index and health care costs in mid-age Australian women. Aust N Z J Public Health, 2008; 32: 150–155.
• Bungum, T., Monica S., Allen W. J. & James M. M. (2003). The relationship of body mass index, medical costs, and job absenteeism. Am Journal Health Behaviour, 2003; 27: 456–462.
• Burton, W. N, Chen, C., Schultz, A. B & Edington, D. W., (1998). The economic costs associated with body mass index in a workplace. Journal of Occupational Environmental Medicine, 1998; 40: 786–792.
• Burton, W. N., Chin-Yu C., Alyssa S. & Dee E., (1999). The costs of body mass index levels in an employed population, Statistical bulletin (Metropolitan Life Insurance Company: 1984) 80(3):8-14 · July 1999
• Cawley, J. ve Chad M., (2012). The medical care costs of obesity: An instrumental variables approach. Journal of Health Economics, Volume 31, Issue 1, 219-230.
• Claessen, H., Volker A., Christoph D. & H Brenner, (2009). Overweight, obesity and risk of work disability: a cohort study of construction workers in Germany. Occupational and Environmental Medicine, 2009; 66(6): 402–409.
• Colditz, GW, Wang, YC., (2008). Economic costs of obesity, In: Hu F, Obesity Epidemiology. New York: Oxford University Press, Inc.,2008.
• Dee, A., Karen K., Ciaran O., Linda S., Anthony S., Victoria O., Sarah F. & Ivan J P. (2014). The direct and indirect costs of both overweight and obesity: a systematic review. BMC Research Notes 2014, 7:242,
• Denison F. C, G. Norrie, B. Graham, J. Lynch, N. Harper & R.M. Reynolds, (2009). Increased maternal BMI is associated with an increased risk of minor complications during pregnancy with consequent cost implications. BJOG An International Journal of Obstetrics & Gynaecology, 116(11):1467-72.
• Dor, A. J D Casey F., B A Ellen L. & Ellen T. (2010). A Heavy Burden: the Individual Costs of Being Overweight and Obese in the United States. George Washington University, School of Public Helath and Helath services, Department of Helath Policy.
• Detournay, B. Fagnani F, Phillippo M, Pribil C, Charles MA, Sermet C, Basdevant A. & Eschwège E., (2000). Obesity morbidity and health care costs in France: an analysis of the 1991–1992 Medical Care Household Survey. International Journal of Obesity, (2000) 24, ss: 151-155.
• Esposti, E. D., Alessandra S., Giorgia V., Mirko Di M., Francesco Z., Anna Rita C., Cristina B., Marco G., Maria G. P. & Luca D. E. (2006). The relationship between body weight and drug costs: an Italian population-based study. Clinical Therapeutics, Volume 28, Number 9, 28: 1472–1481.
• Frezza, E. E., Mitchell S. W. & Bradley T. E., (2006). The impact of morbid obesity on the state economy: an initial evaluation. Surgery for Obesity and Related Diseases, Volume 2, Issue 5, September–October 2006, ss: 504–508
• Finkelstein, E. A., Justin G. T., Joel W. C. & William D., (2009). Annual medical spending attributable to obesity: payer and service specific estimates. Health affairs, 28 (5), ss: 822-831
• Finkelstein, E. A., Marco daCosta D., Somali M. B. & Brent C. H. (2010). The costs of obesity in the workplace. Journal Occup Environ Medicine, 2010, 52(10):971–976.
• Finkelstein, E., Ian C. F. & Guijing W., (2005). The costs of obesity among full-time employees. American Journal of Health Promotion, 2005; 20: 45– 51.
• Finkelstein, E. A., Christopher J. R. & Katherine M. K. (2005). Economic Causes and Consequences of Obesity. Annual Review of Public Health, ABD. 2005:239-257.
• Finkelstein, M. M. (2001). Obesity, cigarette smoking and the cost of physicians’ services in Ontario. Canadian journal of public health, 2001; 92:437–440.
• Finkelstein, E. A., Ian C. F. & Guijing W. (2003). National medical spending attributable to overweight and obesity: how much, and who’s paying?. Health Affairs At the Intersection of Health, Health Care and Policy, 2003; ss: 219–226.
• Ferrie, J. E. , Jenny H., Martin J. S., Jussi V., Michael G. M. & Mika K. (2007). BMI, obesity, and sickness absence in the Whitehall II study. Obesity A Research Journal, 2007; 15: 1554–1564.
• Garde, A. (2010). EU Law and Obesity Prevention. Kluwer Law International, The Netherlands.
• Gates, D. M., Paul S., Bonnie J. B., Gordon L. G. & Benjamin D. S. (2008). Obesity and presenteeism: the impact of body mass index on the workplace productivity. Journal Occup Environ Medicine, 2008;50:39–45.
• Guarino, A. S., (2013). An American Dilemma: The Financila Costs and Economic Impact of Obesity in the United States. Advances in Management, vol. 6, issue 7
• Hacettepe Üniversitesi Nüfus Etütleri Enstitüsü, (2013), Ulusal Hastalık Yükü Çalışması 2013.
• Hammond, R. A & Ruth L., (2010). The economic impact of obesity in the United States, Diabetes, Metabolic Syndrome and Obesity. Targets and Therapy journal, , 2010:3 ss: 285–295
• Hansen CD, Johan H. A., (2009). Sick at work—a risk factor for long-term sickness absence at a later date?. Journal Epidemiol Community Health,” 2009;63:397–402
• Haskins, O. (2013). Mexico: Taxes are a war on obesity, <http:// www.bariatricnews.net/?q=news/111201/mexico-taxes-are-war-obesity>, (Erişim Tarihi: 28.02.2016).
• Hill, R. K., Joseph W. T., Jennifer L. S., Sathiska D. P. & Paula C.-H., (2009), “Self-reported health risks linked to health plan cost and age group. Am J Prev Med, 2009; 36: 468–474.
• Højgaard, B., Kim R. O., Jes S., Thorkild I.A. S. & Dorte G.-H., (2008) Economic Costs of Abdominal Obesity. Obesity Facts, 2008;1: 146–154
• Janssens, H., Clays, E., Kittel, F., De Bacquer, D., C., Annalisa & Braeckman, L. (2012). The association between body mass index class, sickness absence, and presenteeism. Journal of Occupational and Environmental Medicine, 2012; 54(5): 604–609.
• Kanavos, P. Stacey van den A. & Willemien S. (2012). Diabetes expenditure, burden of disease and management in 5 EU countries. LSE Health, London School of Economics
• Katzmarzyk, P. T. & Ian J., (2004). The economic costs Associated with physical ınactivity and obesity in Canada: An Update. Canadian Journal of Applied Physiology, 29 (1), 90-115.
• Klonoff, D. C., (2009). A Sweetened beverage tax ıs needed to combat the obesity epidemic as well as related absenteeism and presenteeism. Journal Of Diabetes Science And Technology, 3 (3), 408
• Koçkaya, G. Fatma Betül Y., Gülpembe E., Kağan A. ve Mehtap T., (2016). Cost effectiveness and economic value of obesity surgery for Turkey (CEVOS-T). Obesity Medicine, 1 (2016) 33-37
• Konnopka, A. Bodemann M, Hans-Helmut K. (2011). Health burden and costs of obesity and overweight in Germany. European Journal of Health Economics, 2011, 12:345–352
• Kuriyama, S. Ichiro T., Takayoshi O., Yukiko A., K Takahashİ, Y Watanabe, Yoshikazu N. & Shigeru H. (2002). Medical care expenditure associated with body mass index in Japan: the Ohsaki Study. International Journal of Obesity, (2002) 26, 1069–1074.
• Kuriyama, S., Atsushi H., Kaori O. Yoshinori S., Yoshikazu N., Kazuki F., Yoshitaka T. & Ichiro T. (2004). Joint impact of health risks on health care charges: 7-year follow-up of National Health Insurance beneficiaries in Japan (the Ohsaki Study). Preventive Medicine Journal, Volume 39, Issue 6, December 2004, ss: 1194–1199
• Lakdawalla, D. N., Dana P. G. & Baoping S., (2005). The health and cost consequences of obesity among the future elderly. Health Affairs At the Intersection of Health, Health Care and Policy. (Millwood) 2005; 24(Suppl. 2): W5R30–W5R41.
• Lehnert, T., Diana S., Alexander K., Steffi R.-H. & Hans-Helmut K., (2013). Economic costs of overweight and obesity. Best Practice & Research Clinical Endocrinology & Metabolism, 27 (2013) 105–115
• Lengerke, T. V., Christian K., (2011). Economic costs of adult obesity: A review of recent European studies with a focus on subgroup-specific costs. Maturitas, 69 (2011) 220–229.
• Levy E, Pierre L., C Le Pen, ve Arnaud B., (1995). The economic cost of obesity: the French situation. International Journal of Obesity, 19(11):788-92.
• Lobstein, T. (2015). Prevalence and costs of obesity. Medıcıne Journal, 43:2, Obesıty And Metabolıc Complıcatıons, Volume 43, Issue 2, February 2015, ss: 77–79.
• Loeppke, R., Michael T., Vince H., Thomas P., Ronald C. K. & Kimberly J., (2009). Health and Productivity as a Business Strategy: A Multi-Employer Study. Journal of Occupational Environmental Medicine, 51(4):411–428, pp. 140-152.
• Long, D A., Reed, R. & Lehman, G. (2006). The cost of lifestyle health risks: obesity. Journal of Occupational & Environmental Medicine, March 2006 - Volume 48 - Issue 3 – ss: 244-251
• Mcgee, D. L., (2005). Body mass index and mortality: a meta-analysis based on person-level data from twenty-six observational studies. Annals of Epidemiology, 15(2): 87–97.
• Mansson, N., Karl-Fredrık E., Bo I., Jonas R., Arne M. & Lennart R., (1996). Body mass index and disability pension in middleaged men–non-linear relations. International Journal of Epidemiology, 25: 80–85.
• Moreau, M., Valente F, Rudolf M., Pelfrene E, P de S., Gui De B. U. ve M Kornıtzer, (2004). Obesity, body fat distribution and incidence of sick leave in the Belgian workforce: the Belstress study. Internatıonal Journal Of Obesıty, 28(4). Ss:574-582
• Nakamura, K. Tomonori O., Hideyuki K., Takehito H., Akira O. & Hirotsugu U., (2007). Medical costs of obese Japanese: a 10-year follow-up study of National Health Insurance in Shiga, Japan. European Journal of Public Health, Vol. 17, No. 5, 424–429
• Narbro, K, Agren G, Jonsson E, Larsson B, Näslund I, Wedel H, Sjöström L., (1999). Sick leave and disability pension before and after treatment for obesity: a report from the Swedish Obese Subjects (SOS) study. International Journal of Obesity & Related Metabolic Disorders, Jun1999, Vol. 23 Issue 6, p619. 6p.
• Neovius, K, Kari J., S. Rössner & Martin N., (2008). Disability pension, employment and obesity status: a systematic review. Obesity Reviews, 2008; 9(6): 572–581.
• Oster, G., John E., Amy K. O. & David T., (2000). The clinical and economic burden of obesity in a managed care setting. The Amerıcan Journal Of Managed Care, 2000; 6: 681–689.
• Østbye, T. John M. D. & Katrina M. K., (2007). Obesity and workers’ compensation: results from the Duke Health and Safety Surveillance System. Archives of Internal Medicine, 2007; 167(8): 766–773.
• Pendergast, K., Anne W., Beth S. Xiaolei Z., Louis J. A., Ian C., Nicholas F., Hans H., James H., Luc Van G., Florence C. & Jean-Pierre D., (2010). Impact of waist circumference difference on health-care cost among overweight and obese subjects: the PROCEED cohort. Value In Health, 2010;13 ss:402–10.
• Popkin, B. M, Soowon K., Du R. E., C. Zizza & S Du, (2006). Measuring the full economic costs of diet, physical activity and obesity-related chronic diseases. Obesity Reviews, 7(3):271-93.
• Pronk, N., M., Brian, K., Ronald C., B., Arne L., S., Gregory E. & W., Philip, (2004). The association between work performance and physical activity, cardiorespiratory fitness, and obesity. Journal Occup Environ Medicine, 2004; 46: 19–25.
• Raebel, M. A., Daniel C. M., Douglas A. C., Stanley X., Julie A. P. & Frances A. L., (2004). Health services use and health care costs of obese and nonobese individuals. Arch Intern Med. 2004;164:2135-2140
• Ricci, J. A. ve Elsbeth C.(2005).Lost productive time associated with excess weight in the U.S. workforce. Journal Occup Environ Medicine, 2005; 47: 1227–1234.
• Sağlık Bakanlığı. (2011). Türkiye sağlıklı beslenme ve hareketli hayat rogramı (2010-2014), (2. Baskı), Ankara: TC Sağlık Bakanlığı Temel Sağlık Hizmetleri Genel Müdürlüğü, Yayın No: 773.
• Saruç, T.(2015). Obezite Ekonomisi, Seçkin yayıncılık, Ankara
• Schmid, A., Heinz S., Alain G. & Ulrich K., (2005).Economic burden of obesity and its comorbidities in Switzerland. International Journal of Public Health, 50, 2, ss: 87-94.
• Schmier, J. K., Mechelle L J. & Michael T H., (2006).Cost of obesity in the workplace. Scandinavian Journal of Work Environment & Health, 2006; 32(1): 5–11.
• Serxner, S. A., Gold, D. B., B., Karin K., (2001).The impact of behavioral health risks on worker absenteeism. Journal Occup Environ Medicine, 2001; 43: 347–354.
• Sichieri, R., Sileia do N. & Walmir C., (2007).The burden of hospitalization due to overweight and obesity in Brazil. Cadernos de Saúde Pública, 2007; 23: 1721–1727.
• Stewart, W. F., Judith A. R., Elsbeth C. & David M., (2003).Lost productive work time costs from health conditions in the United States: Results from the American Productivity Audit. Journal of Occupational and Environmental Medicine, 45, ss: 1234-1246.
• Stuart, B., Jennifer L., Lirong . & Sachin K., (2008).Obesity, disease burden, and prescription spending by community-dwelling Medicare beneficiaries. Journal Current Medical Research and Opinion, Volume 24, 2008 - Issue 8, ss: 2377–2387.
• Sturm, R., (2002).The Effects of Obesity, Smoking and Drinking on Medical Problems and Cost. Health Affairs, 21, No.2, 2002: 245-253.
• Swinburn, B., Toni A., J Gillespie, John B., A Menon, David S. & Brian COX, (1997), “Health care costs of obesity in New Zealand”, International Journal of Obesity, 21(10):891-6, November 1997.
• Thompson, D., John E., Graham A. C., Amy P. B. & Gerry O., (1999).Lifetime health and economic consequences of obesity. Arch Intern Med, 1999; 159: 2177–2183.
• Thompson, D., Jonathan B. B., Gregory A. N., Patricia J. E. & Gerry O., (2001).Body mass index and future healthcare costs: a retrospective cohort study. Obesıty Research, Vol. 9 No. 3 March 2001, ss: 210–218.
• Thorpe, K. E., Curtis S. F., David H. H. & Peter J., (2004).The impact of obesity on rising medical spending. Health Affairs, 23, 480-486
• Trogdon, J. G, Eric F., Thomas H., Pam S D. & Sachin K.L-B., (2008).Indirect costs of obesity: a review of the current literatüre. Obesity Reviews, 2008; 9(5): 489–500.
• Tsai, S. P., Wendt, J. K., Ahmed, F. S., D., Robin P., S., Thomas R., (2005).Illness absence patterns among employees in a petrochemical facility: impact of selected health risk factors. Journal of Occupational Environmental Medicine, 2005; 47: 838–846.
• Tucker, L. A. & Friedman G. (1998).Obesity and absenteeism: an epidemiologic study of 10 825 employed adults. American Journal of Health Promotion, 1998; 12: 202–207.
• Vellinga, A., Diarmuid O. & Davida D. L. H., (2008).Length of stay and associated costs of obesity related hospital admissions in Ireland. BMC Health Serv Res, 2008; 8: 88.
• Yach, D., David S. & Kelly D B., (2006).Epidemiologic and economic concequences of the global epidemics of obesity and diabetes. Nature Medicine, Volume 12, Number 1, 62-66.
• Yang, Z. & Allyson G H., (2008).The financial burden of overweight and obesity among elderly Americans: the dynamics of weight, longevity, and health care cost. Health Serv Res, 43: 849– 868.
• Zhao W. H., Y Zhai, Hu JP, Jianxin W., Yang Z., Kong L. & Chen C. (2008).Economic burden of obesity-related chronic diseases in Mainland China. Obesity Reviews, 9 Suppl 1(s1):62-7.
• Wee, C. C., Russell S. Phillips, Anna T. R. Legedza, Roger B. D., Jane R. S., Graham A. C. & Mary Beth H., (2005).Health care expenditures associated with overweight and obesity among US adults: importance of age and race. American Journal of Public Health, 2005; 95: 159–165.
• Withrow, D., Alter, D.A. (2011). The Economic Burden of Obesity Woldwide: A systematic Review of the Direct Costs of Obesity. Obesity Reviews, 12 (2), 131-141
• Wolf A. M & Colditz, G. A, (1996).Social and economic effects of body weight in the United States. American Journal of Clinical Nutrition, 1996; 63(3 Suppl.) ss: 466–469.İnternet Kaynakları
• http://www.who.int/gho/countries/en/ (Erişim Tarihi: 21/02/2018)
• http://www.mckinsey.com/mgi/overview(Erişim Tarihi: 01/11/2017)
• https://www.nhlbi.nih.gov/files/docs/guidelines/ob_gdlns.pdf(Erişim Tarihi: 11/04/2018)www.cdc.gov/nccdphp/dnpa/Obesity/economic_consequences.htm (Erişim Tarihi: 05/03/2018)