Economic costs attributable to modifiable risk factors: an analysis of 24 million urban residents in China

作者：Xuechen Xiong, Zhaohua Huo, Yinan Zhou, David Bishai, Karen A. Grépin, Philip Clarke, Cynthia Chen, Li Luo, Jianchao Quan · 发表于：BMC Medicine · 年份：2024 · DOI：10.1186/s12916-024-03772-7 · 被引用次数：9 · 研究领域：Healthcare Systems and Reforms、Global Health Care Issues、Global Maternal and Child Health

BACKGROUND: Estimating the economic burden of modifiable risk factors is crucial for allocating scarce healthcare resources to improve population health. We quantified the economic burden attributable to modifiable risk factors in an urban area of China. METHODS: Our Shanghai Municipal Health Commission dataset covered 2.2 million inpatient admissions for adults (age ≥ 20) in public and private hospitals in 2015 (1,327,187 admissions) and 2020 (837,482 admissions). We used a prevalence-based cost-of-illness approach by applying population attributable fraction (PAF) estimates for each modifiable risk factor from the Global Burden of Diseases Study (GBD) to estimate attributable costs. We adopted a societal perspective for cost estimates, comprising direct healthcare costs and productivity losses from absenteeism and premature mortality. Future costs were discounted at 3% and adjusted to 2020 prices. RESULTS: In 2020, the total societal cost attributable to modifiable risk factors in Shanghai was US$7.9 billion (95% uncertainty interval [UI]: 4.6-12.4b), mostly from productivity losses (67.9%). Two health conditions constituted most of the attributable societal cost: cancer (51.6% [30.2-60.2]) and cardiovascular disease (31.2% [24.6-50.7]). Three modifiable risk factors accounted for half of the total attributable societal cost: tobacco (23.7% [16.4-30.5]), alcohol (13.3% [8.2-19.7]), and dietary risks (12.2% [7.5-17.7]). The economic burden varied by age and sex; most of the ...