Association between Obesity and Medical Care Expenditure among Taiwanese Adults

臺灣成人肥胖與醫療費用之關係

Hsiao-Yun Hu ； Yiing-Jenq Chou ； Pesus Chou ； Cheng-Hua Lee ； Miaw-Chwen Lee ； Nicole Huang

《Asia Pacific Journal of Clinical Nutrition》 17卷3期 (2008/09) Pp. 492-504

https://doi.org/10.6133/apjcn.2008.17.3.18

摘要

本研究之目的為評估臺灣成人肥胖與醫療費用之關係，並進一步分析性別、年齡及社經地位之影響。研究樣本為2001年國民健康訪問調查中有簽署同意連結健保資料庫之18歲以上受訪者，共計12250人。依據亞太地區身體質量指數作為肥胖定義。研究顯示二級肥胖與一級肥胖的男性相對於正常男性分別高出44.6% (95%CI: 27.1%-68.7%) 及 39.5% (95%CI: 39.4%-41.2%)的醫療費用。而二級肥胖與一級肥胖的女性分別比正常女性高出93.3% (95%CI: 69.9%-114.6%)及56.1% (95%CI: 50.4%-61.4%)的醫療費用。在控制相關因素後，每個年齡層皆呈現BMI 越高醫療費用越高，且年齡層越高越明顯。在不同的社經地位也顯示隨著BMI 增加醫療費用皆逐漸增加，此現象在低社經地位的女性特別明顯，但卻沒有出現於低收入的男性。整體而言BMI 與醫療費用有顯著正相關，且隨著性別、年齡及社經地位有明顯之變化。建議未來擬定肥胖相關醫療費用策略時應進一步考慮相關人口學因素。

關鍵字

肥胖 ； 身體質量指數 ； 醫療費用 ； 社經地位 ； 臺灣

並列摘要

The aim of this study is to evaluate the relationships between obesity and medical care expenditure among Taiwanese adults and to assess the influence of sex, age and socioeconomic status. Our study sample consisted of 12,250 adults aged 18 years or older from the 2001 National Health Interview Survey (NHIS), who had consented to the linking of their survey responses with their NHI claims records. Obesity was defined by Body Mass Index based on the WHO-Asia Pacific categories. Adjusted expenditure for obese class II and class I men were, respectively, 44.6% (95%CI: 27.1%-68.7%) and 39.5% (95%CI: 39.4%-41.2%) greater than normal weight men. For obese class II and class I women, the adjusted expenditure were, respectively, 93.3% (95%CI: 69.9%- 114.6%) and 56.1% (95%CI: 50.4%-61.4%) greater than normal weight women. After adjusting for other factors, higher medical care expenditure was associated with a higher BMI for each age group. The relative magnitude of the association became more apparent as age increased. Annual medical care expenditure increased as the BMI increased among women, which was particularly apparent among low socioeconomic status women. On the other hand, the relationship between BMI and medical care expenditure in men varied by household income. In conclusion, there is a strong positive relationship between higher BMI and increased medical care expenditure and this varies according to sex, age and socioeconomic status. Our findings suggest that projections of future health care costs attributable to obesity will need to take into consideration the demographic make-up of the obese population.

並列關鍵字

obesity ； body mass index ； medical care expenditure ； socioeconomic status ； Taiwan