Relative contribution of overweight and obesity to rising public hospital in-patient expenditure in South Australia

2019 ◽  
Vol 43 (2) ◽  
pp. 148 ◽  
Author(s):  
Allison Larg ◽  
John R. Moss ◽  
Nicola Spurrier
Keyword(s):  
Population Health ◽  
Obesity Prevention ◽  
Public Hospital ◽  
Financial Burden ◽  
Hospital Costs ◽  
South Australia ◽  
Overweight And Obesity ◽  
Public Healthcare ◽  
Relative Contribution ◽  
Expenditure Growth

Objective Arguments to fund obesity prevention have often focused on the growing hospital costs of associated diseases. However, the relative contribution of overweight and obesity to public hospital expenditure growth is not well understood. This paper examines the effect of overweight and obesity on acute public hospital in-patient expenditure in South Australia over time compared with other expenditure drivers. Methods Annual inflation-adjusted acute public admitted expenditure attributable to a high body mass index was estimated for 2007–08 and 2011–12 and compared with other expenditure drivers. Results Expenditure attributable to overweight and obesity increased by A$45million, from 4.7% to 5.4% of total acute public in-patient expenditure. This increase accounted for 7.8% of the A$583million total expenditure growth, whereas the largest component of total growth (62.4%) was a real increase in the average cost per separation. Conclusions The relatively minor contribution of overweight and obesity to expenditure growth over the time period examined invites reflection on arguments to boost preventive spending that centre upon reducing hospital costs. These arguments may inadvertently detract attention from the considerable health and social burdens of overweight and obesity and from unrelated sources of expenditure growth that reduce opportunities for state governments to fund obesity prevention programs despite their comparative benefits to population health. What is known about the topic? Stand-alone estimates suggest that overweight and obesity are placing a considerable financial burden on the Australian public healthcare system. What does this paper add? Our findings challenge common perceptions about the relative importance of overweight and obesity in the context of rising public in-patient expenditure in Australia. What are the implications for practitioners? Consistent serial estimates of overweight- and obesity-attributable expenditure enable its tracking and comparison with other potentially controllable expenditure drivers that may also warrant attention. Explicit consideration of population health trade-offs in expenditure-related decisions, including in enterprise bargaining, would enhance transparency in priority setting.

scholarly journals Overweight and Obesity among Russian, Somali, and Kurdish Origin Populations in Finland

2019 ◽  
Vol 53 ◽  
pp. 73-88
Author(s):  
Natalia Skogberg ◽  
Adam Adam ◽  
Tarja Kinnunen ◽  
Eero Lilja ◽  
Anu Castaneda
Keyword(s):  
Health Promotion ◽  
General Population ◽  
Population Health ◽  
Obesity Prevention ◽  
Migrant Health ◽  
Overweight And Obesity ◽  
Lower Prevalence ◽  
Foreign Born ◽  
Health And Wellbeing ◽  
Obesity Prevention Programs

Previous studies have shown the prevalence of overweight and obesity to be higher in foreign-born populations than their native counterparts. This study aimed at assessing the prevalence of overweight and obesity in Russian, Somali and Kurdish origin populations in Finland in comparison with the general population, and determining which background factors associate with overweight and obesity. Data from the Finnish Migrant Health and Wellbeing Study (Maamu) were used. Prevalence of overweight and obesity was as high as 73% in Somali and 65% in Kurdish origin women. In contrast, Somali origin men had a significantly lower prevalence of overweight and obesity than men in the general population. Health promotion measures must be addressed towards decreasing the prevalence of overweight and obesity particularly among Somali and Kurdish origin women. Foreign-born people need to be taken into account when planning and implementing obesity prevention programs.

scholarly journals Hispanic Maternal Perception of Preschoolers’ Bodyweight Status in Samples from the United States of America and Mexico

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 1101-1101
Author(s):  
Summer Wilmoth ◽  
Yolanda Flores-Peña ◽  
Leah Carrillo ◽  
Elana Martinez ◽  
Erica Sosa ◽  
...  
Keyword(s):  
United States ◽  
Childhood Obesity ◽  
Obesity Prevention ◽  
Weight Status ◽  
The United States ◽  
Overweight And Obesity ◽  
Actual Rate ◽  
Actual Weight ◽  
Hispanic Mothers ◽  
The Us

Abstract Objectives Childhood obesity is a major public health concern, which disproportionally affects Hispanic children in the United States (US) and Mexico. Mothers are key influencers to their children's health and growth. As part of a pilot obesity prevention study, Hispanic mothers’ perception of their preschoolers’ weight status was assessed to inform the development of intervention strategies. Methods Study subjects were Hispanic mothers and their preschoolers between the ages of 3 and 5 enrolled in participating Head Star Centers in Texas, US or kindergartens in Northern Mexico. Upon informed consent, mothers completed a self-administered questionnaire assessing their perception of their preschoolers’ weight status. Preschoolers’ body weight and height were measured; and their actual weight status was classified using the CDC's age and gender specific BMI references. Results Preliminary data included 85 and 294 child-mother pairs from US and Mexico, respectively. The US sample had a higher rate of overweight and obesity (35%) in comparison to the Mexico sample (19%). There was a great discrepancy between mothers’ perception and their children's actual weight status in both samples. Although only approximately 5% of children were underweight, 14% of American and 24% of Mexican mothers perceived their children being underweight. Contrarily, only 4.8% of American mothers perceived their children as a little overweight or obese, as compared to the actual rate of 35%. Similarly, only 5% of Mexican mothers perceived their children as a little overweight or obese, as compared to the actual rate of 19%. Conclusions Hispanic mothers in the US and Mexico appear to worry about their normal weight children being underweight, while overlooking the overweight and obesity problem. Early childhood obesity prevention programming is needed to aggressively address Hispanic mothers’ preference of chubby children, and the mothers’ underestimation of overweight and obesity among their preschoolers. Funding Sources The Mexico's National Science and Technology Council & The Kellogg´s Institute of Nutrition and Health.

PP339 A Budget Impact Model Of The EluviaTM Drug-Eluting Stent from The Australian Public Hospital And National Payer Perspective

2020 ◽  
Vol 36 (S1) ◽  
pp. 29-29
Author(s):  
Nishath Altaf ◽  
Thathya V. Ariyaratne ◽  
Adrian Peacock ◽  
Irene Deltetto ◽  
Jad El-Hoss ◽  
...  
Keyword(s):  
Lower Limb ◽  
Public Hospital ◽  
Budget Impact ◽  
Healthcare Payer ◽  
Drug Eluting Stent ◽  
Public Healthcare ◽  
Impact Model ◽  
Drug Eluting ◽  
Budget Impact Model ◽  
Zilver Ptx

IntroductionImproving long-term outcomes like target lesions revascularizations (TLRs) is a focus for endovascular interventions aimed at treating symptomatic lower-limb peripheral arterial disease (PAD). EluviaTM, a paclitaxel-eluting drug-eluting stent (DES) was shown to further reduce TLRs when compared with the paclitaxel-coated Zilver® PTX® stent in the IMPERIAL trial, a global, randomized controlled study. This budget-impact evaluation investigated cost-savings from Eluvia-use when compared with Zilver PTX, relying on the 12- to 24-month outcomes from the IMPERIAL trial.MethodsA budget-impact model comparing Eluvia and Zilver PTX was developed from the Australian public healthcare payer, and an individual hospital perspective, with a 5-year time-horizon. Observed trial results were applied to each year's incident population and associated costs, and no extrapolation was conducted. The analysis used publicly available Australian national hospital cost data, population estimates, procedural statistics, epidemiological literature, and data from public hospital audits to verify eligible population for endovascular procedures (EVP) including DES. All costs were captured in Australian dollars (AUD), where AUD 1 = USD 0.69 (June 2020).ResultsAssuming 80-percent EVP eligibility, and a DES-use range of 10–28 percent, the 5-year model estimated potential national savings of AUD 4.3–12.1 million (M) [USD 3–8.3M] to the public healthcare payer, driven by reduced TLRs from Eluvia-use compared with Zilver-PTX. The model projected potential national savings of AUD 33.1–92.6M (USD 22.8–63.9M) to individual hospitals through reduced hospital bed days for adverse events (AE). The model forecasted 14,428–40,399 treated patients; 1,499–4,198 fewer TLRs; and 16,515–46,243 fewer hospital days for AE. At a state level, projected hospital savings were: New South Wales AUD 10.9–30.7M [USD 7.5–21.1M]; Victoria AUD 8.4–23.4M [USD 5.8–16.1M]; Queensland AUD 6.5–18.3M [USD 4.5–12.6M]; Western Australia AUD 3.4–9.5M [USD 2.3–6.5M]; South Australia AUD 2.3–6.4M [USD 1.6–4.4M].ConclusionsTreatment of symptomatic lower-limb PAD with the Eluvia DES could lead to potential savings for the Australian healthcare system, at the national, state, and the local hospital level, based on improved patient outcomes.

scholarly journals Costs of postoperative morbidity following paediatric cardiac surgery: observational study

2020 ◽  
Vol 105 (11) ◽  
pp. 1068-1074 ◽  
Author(s):  
Emma Hudson ◽  
Katherine Brown ◽  
Christina Pagel ◽  
Jo Wray ◽  
David Barron ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Cohort Study ◽  
Health Service ◽  
Financial Burden ◽  
Hospital Costs ◽  
Incidence Rates ◽  
Care Quality ◽  
Patient Costs ◽  
Paediatric Cardiac Surgery ◽  
The Uk

ObjectiveEarly mortality rates for paediatric cardiac surgery have fallen due to advancements in care. Alternative indicators of care quality are needed. Postoperative morbidities are of particular interest. However, while health impacts have been reported, associated costs are unknown. Our objective was to calculate the costs of postoperative morbidities following paediatric cardiac surgery.DesignTwo methods of data collection were integrated into the main study: (1) case-matched cohort study of children with and without predetermined morbidities; (2) incidence rates of morbidity, measured prospectively.SettingFive specialist paediatric cardiac surgery centres, accounting for half of UK patients.PatientsCohort study included 666 children (340 with morbidities). Incidence rates were measured in 3090 consecutive procedures.MethodsRisk-adjusted regression modelling to determine marginal effects of morbidities on per-patient costs. Calculation of costs for hospital providers according to incidence rates. Extrapolation using mandatory audit data to report annual financial burden for the health service.Outcome measuresImpact of postoperative morbidities on per-patient costs, hospital costs and UK health service costs.ResultsSeven of the 10 morbidity categories resulted in significant costs, with mean (95% CI) additional costs ranging from £7483 (£3–£17 289) to £66 784 (£40 609–£103 539) per patient. On average all morbidities combined increased hospital costs by 22.3%. Total burden to the UK health service exceeded £21 million each year.ConclusionPostoperative morbidities are associated with a significant financial burden. Our findings could aid clinical teams and hospital providers to account for costs and contextualise quality improvement initiatives.

scholarly journals Prevention of overweight and obesity in early life

2018 ◽  
Vol 77 (3) ◽  
pp. 247-256 ◽  
Author(s):  
Julie Lanigan
Keyword(s):  
Risk Factors ◽  
Obesity Prevention ◽  
Early Life ◽  
Complex Interventions ◽  
Adult Life ◽  
Overweight And Obesity ◽  
Childhood Weight ◽  
Increased Risk ◽  
Randomised Controlled ◽  
The Uk

Childhood obesity is a serious challenge for public health. The problem begins early with most excess childhood weight gained before starting school. In 2016, the WHO estimated that 41 million children under 5 were overweight or obese. Once established, obesity is difficult to reverse, likely to persist into adult life and is associated with increased risk of CVD, type 2 diabetes and certain cancers. Preventing obesity is therefore of high importance. However, its development is multi-factorial and prevention is a complex challenge. Modifiable lifestyle behaviours such as diet and physical activity are the most well-known determinants of obesity. More recently, early-life factors have emerged as key influencers of obesity in childhood. Understanding risk factors and how they interact is important to inform interventions that aim to prevent obesity in early childhood. Available evidence supports multi-component interventions as effective in obesity prevention. However, relatively few interventions are available in the UK and only one, TrimTots, has been evaluated in randomised controlled trials and shown to be effective at reducing obesity risk in preschool children (age 1–5 years). BMI was lower in children immediately after completing TrimTots compared with waiting list controls and this effect was sustained at long-term follow-up, 2 years after completion. Developing and evaluating complex interventions for obesity prevention is a challenge for clinicians and researchers. In addition, parents encounter barriers engaging with interventions. This review considers early-life risk factors for obesity, highlights evidence for preventative interventions and discusses barriers and facilitators to their success.

scholarly journals Childhood Overweight and Obesity Prevention

2008 ◽  
Vol 123 (3) ◽  
pp. 258-259 ◽  
Author(s):  
Steven K. Galson
Keyword(s):  
Obesity Prevention ◽  
Childhood Overweight ◽  
Overweight And Obesity ◽  
Childhood Overweight And Obesity

Have Education and Publicity about Depression Made a Difference? Comparison of Prevalence, Service use and Excess Costs in South Australia: 1998 and 2004

2007 ◽  
Vol 41 (1) ◽  
pp. 38-53 ◽  
Author(s):  
Robert D. Goldney ◽  
Robert D. Goldney ◽  
Laura J. Fisher ◽  
Eleonora Dal Grande ◽  
Anne W. Taylor ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Community Education ◽  
Financial Burden ◽  
South Australia ◽  
Community Services ◽  
Depression Symptoms ◽  
The South ◽  
Prevalence Of Depression ◽  
Excess Costs

Objective: To identify changes in depression, its management and associated excess costs, between 1998 and 2004 in South Australia. Methods: A face-to-face Health Omnibus Survey was conducted in 2004 among 3015 randomly selected participants aged 15 years and over, who were a random and representative sample of the South Australian population, and this was compared with a survey conducted in 1998 that used the same methodology. The main outcome measures were prevalence of depression detected by the Mood Module of the Primary Care Evaluation of Mental Disorders (PRIME-MD); use of health services; health-related quality of life assessed by the Assessment of Quality of Life; estimates of excess costs and demographic data. Results: There was no significant change in the overall prevalence of depression, although there was a significant decrease in respondents with other depressions, and a non-significant increase in those with major depression. No significant differences in the mean number of PRIME-MD depression symptoms were reported. Greater use of predominantly non-medical treatment services and antidepressants were reported by both those with depression and those without depression. There was a marked increase in the associated excess costs of depression. Conclusions: There has been no significant improvement in the prevalence of depression and its associated morbidity and financial burden in the South Australian community between 1998 and 2004, despite a number of professional and community education programmes. It is possible that without these efforts and the increased treatment reported on in this survey, there may have been an increase in the prevalence of depression and an even greater financial burden. However, it is also possible that community services for the provision of treatment for depression have not been able to implement research strategies that have been demonstrated to be effective.

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