Exp Clin Endocrinol Diabetes 2019; 127(01): 62-67
DOI: 10.1055/a-0630-0318
Article
© Georg Thieme Verlag KG Stuttgart · New York

Expenditures Of Metabolic Diseases – An Estimation on National Health Care Expenditures of Diabetes and Obesity, Hungary 2013

Gabriella Iski
1   Faculty of Public health, Department of Family and Occupational Medicine, University of Debrecen, Debrecen, Hungary
,
Sarolta E. Rurik
2   Independent macroeconomic adviser
,
Imre Rurik
1   Faculty of Public health, Department of Family and Occupational Medicine, University of Debrecen, Debrecen, Hungary
› Author Affiliations
Further Information

Publication History

received 18 November 2017
revised 18 November 2017

accepted 07 May 2018

Publication Date:
02 July 2018 (online)

Abstract

Background Obesity could be considered as the main consequence of unhealthy nutrition, responsible for many pathological alterations in human. Obese patients usually need more health care services. The aim of the study was to estimate the financial expenditures of health care provisions in Hungary, related to obesity and diabetes, as its main pathological consequence.

Methods Data of the Hungarian National Health Insurance Fund (NHIF) were collected for 2013, regarding finances of secondary care, hospital services, reimbursement for medications and healing aids of diabetic patients together with selected morbidities linked to obesity, based on the codes of the International Classification of Diseases (ICD) and calculated their population prevalence on the population-attributable fraction (PAF).

Results Financial data regarding diabetes care resulted in a 40,311 Million HUF (129 Million EUR) national fund expenses, beside a 7,173 Million HUF (23 Million EUR) contribution from patients. Estimated total health care expenditures related to obesity were 58,986 Million HUF (188 Million EUR) and the financial contribution of patients was calculated as 25,316 Million HUF (81 Million EUR). These data represent a 5.2% and 9.3% of the whole national health services, 16% and 30% of the whole drug-reimbursement budgets, respectively.

Conclusions Although expenditures for some obesity related pathologies analyzed in this paper represent 0.28% of the national GDP, considering other morbidities and other patient’s expenses, the real ratio could be between 0.5–1%. The increasing number of overweight and obese persons requires more focus in public health, higher awareness in the society and more governmental support.

 
  • References

  • 1 Flegal KM, Graubard BI, Williamson DF. et al. Excess deaths associated with underweight, overweight, and obesity. JAMA 2005; 293: 1861-1867
  • 2 Must A, Spadano J, Coakley EH. et al. The disease burden associated with overweight and obesity. JAMA 1999; 282: 1523-1529
  • 3 Kleinert S, Horton R. Rethinking and reframing obesity. Lancet 2015; 385: 2326-2328
  • 4 Thorpe KE, Florence CS, Howard DH. et al. The impact of obesity on rising medical spending. Health Aff 2004; 4: 480-486
  • 5 Zhang P, Shrestha SS, Li R. Economic Costs of Obesity. in: Bray GA, Bouchard C.. (eds) Handbook of Obesity. 3. rev ed. Epidemiology, etiology, and physiopathology. Boca Raton: CRC Press; 2014: 489-503
  • 6 Luo W, Morrison H, de Groh M. et al Chronic diseases in Canada, The burden of adult obesity in Canada. Public Health Agency of Canada 2007; 27: 135-144
  • 7 Tjepkema M. Measured obesity – adult obesity in Canada: Measured height and weight. Canadian Community Survey. Statistics Canada Catalogue 2005; 82: 620
  • 8 Vokó Z, Nagyjánosi L, Kaló Z. The direct medical costs of diabetes in Hungary. LAM 2009; 19: 775-780 in Hungarian
  • 9 Boncz I, Sebestyén A. Financial deficits in the health services of the UK and Hungary. Lancet 2006; 368: 918
  • 10 Boncz I, Nagy J, Sebestyén A. et al. Financing of health care services in Hungary. Eur J Health Econom 2004; 5: 252-258
  • 11 World Health Organisation, Hungary: http://www.who.int/classifications/icd/en/ Accessed 15.11.2015
  • 12 National Health Insurance Fund, Hungary (Országos Egészségbiztosítási Pénztár), ( http://www.oep.hu/felso_menu/szakmai_oldalak/gyogyito_megeleozo_ellatas/adatbazisok/torzsek Accessed 27.11.2015
  • 13 Hungarian Central Statistical Office (Központi Statisztikai Hivatal) https://www.ksh.hu/docs/hun/xstadat/xstadat_eves/i_qse007f.html Accessed 15.11.2015
  • 14 https://www.ksh.hu/docs/hun/xstadat/xstadat_eves/i_fea001.html Accessed15.11. 2015
  • 15 https://www.ksh.hu/docs/hun/xstadat/xstadat_eves/i_qpt001.html Accessed 20.08.2015
  • 16 Hungarian State Treasury: http://www.allamkincstar.gov.hu/hu/koltsegvetesi-informaciok/koltsegvetes_merleg_4/225/ Accessed 18.08.2015
  • 17 Finkelstein EA, Fiebelkorn IC, Wang G. State-level estimates of annual medical expenditures attributable to obesity. Obes Res 2004; 12: 18-24
  • 18 Colditz GA. Economic costs of obesity and inactivity. Med Sci Sports Exerc 1999; 31: 663-667
  • 19 Anis AH, Zhang W, Bansback N. et al. Obesity and overweight in Canada: An updated cost-of-illness study. Obes Rev 2010; 11: 31-40
  • 20 Zhao W, Zhai Y, Hu J. et al. Economic burden of obesity-related chronic diseases in Mainland China. Obes Rev 2008; 9: 62-67
  • 21 Colagiuri S, Lee CMY, Colagiuri R. et al. The cost of overweight and obesity in Australia. Med J Aust 2010; 192: 260-264
  • 22 Detournay B, Fagnani F, Phillippo M. et al. Obesity morbidity and health care costs in France: An analysis of the 1991–1992 Medical Care Household Survey. Int J Obes Relat Metab Disord 2000; 24: 151-155
  • 23 Kuriyama S. Impact of overweight and obesity on medical care costs, all-cause mortality, and the risk of cancer in Japan. J Epidemiol 2006; 16: 139-144
  • 24 Simon GE, Arterburn D, Rohde P. et al. Obesity, depression, and health services costs among middle-aged women. J Gen Intern Med 2011; 26: 1284-1290
  • 25 Hu HY, Chou YJ, Chou P. et al. Association between obesity and medical care expenditure among Taiwanese adults. Asia Pac J Clin Nutr 2008; 17: 492-504
  • 26 Thompson D, Edelsberg J, Kinsey KL. et al. Estimated economic costs of obesity to U.S. Business. Am J Health Promot 1998; 13: 120-127
  • 27 Baji P, Brodszky V, Rencz F. et al. Health status of the Hungarian population between 2000-2010. Orv Hetil 2015; 156: 2035-2044 in Hungarian
  • 28 Rurik I, Ungvári T, Szidor J. et al. Obese Hungary. Trend and prevalence of overweight and obesity in Hungary, 2015. Orv Hetil 2016; 157: 1248-1255 in Hungarian
  • 29 Rurik I, Torzsa P, Szidor J. et al. A public health threat in Hungary: Obesity, 2013. BMC Public Health 2014; 14: 798
  • 30 Roos E, Laaksonen M, Rahkonen O. et al. Weight change and sickness absence-a prospective study among middle-aged employees. Eur J Public Health 2015; 25: 263-267
  • 31 Torzsa P, Keszei A, Kalabay L. et al. Socio-demographic characteristics, health behaviour, co-morbidity and accidents in snorers: A population survey. Sleep and Breathing 2011; 15: 809-818
  • 32 Szakács Z, Ádám Á, Annus JK. et al. Hungarian Society for Sleep Medicine guideline for detecting drivers with obstructive sleep apnea syndrome]. Orv Hetil 2016; 157: 892-900
  • 33 Ilyés I, Jancsó Z, Kovács E. et al. Continuing care of patients with cardiovascular risk in general practice: Diabetic patients and their care]. Orv Hetil 2005; 146: 2581-2588
  • 34 Hungarian Society for the Study of Obesity: http://elhizastudomany.hu/newsite/wp-content/uploads/2015/07/Halmy-E-Azelh %C3 %ADz %C3 %A1s-jelent %C5 %91s %C3 %A9ge…-Folpress-2015.pdf Accessed 07.12.2015
  • 35 Jancsó Z, Márton H, Simay A. et al. The effect of eating habits on cardiovascular risk factors and the assessed cardiovascular risk. Acta Alimentaria 2011; 40: 254-261