Skip to main content

Table 2 Profile of selected studies

From: Cost analyses of obesity in Canada: scope, quality, and implications

Author, year

(Finkelstein 2001)[24]

(Patra, Popova et al. 2007)[23]

(Birmingham, Muller et al. 1999)[22]

(Tarride, Haq et al. 2012)[27]

(Janssen, Lam et al. 2009 2[8]

(Katzmarzyk and Janssen 2004)[28]

(Moffatt, Shack et al. 2011)[26]

(Anis, Zhang et al. 2009)[11]

(Kuhle, Kirk et al. 2011)[7]

(Ohinmaa, Langille et al. 2011)[21]

QHES score

82

77

86

94

85

85

85

97

94

91

Year of cost determination

1994

1997

1997

2000

2000

2001

2005

2006

2006

2009

Settings

Ontario

Canada

Canada

Ontario

Ontario

Canada

Canada

Canada

Nova Scotia

Nova Scotia

Objective regarding costs

To compute direct estimates of the costs of physicians' services in Ontario in relation to Body Mass Index (BMI) and smoking

To estimate the economic cost of chronic disease in Canada

To estimate the direct costs related to the treatment of and research into Obesity in Canada in 1997.

To present an overview of the human and economic burden associated with BMI categories in Ontario, Canada, costs associated with hospitalization, same day procedures and physician visits

To perform an obesity cost-of-illness analysis for individuals living in the province of Ontario, Canada

To estimate the direct and indirect economic costs of physical inactivity and obesity in Canada in 2001

To estimate the direct and indirect costs associated with overweight and obesity

To estimate the economic burden of illness because of overweight and obesity in Canada

To assess health service use and costs across categories of weight status

To estimate the costs associated with implementing and maintaining comprehensive school health.

Approach

Prevalence-based

Prevalence-based

Prevalence-based

Prevalence-based

Prevalence-based

Prevalence-based

Prevalence-based

Prevalence-based

Incidence-based

Top-down costing

Data source

NPHS 1995/6.

Literature searches

- NPHS 1994/5.

- CCHS 1.1.

- CCHS 2000-1.

- CCHS 2001.

- CCHS 2004/5.

- National Health Expenditure Database.

2003 Children’s Lifestyle and School Performance Study (CLASS).

Accounting information of all schools in the Annapolis Valley Health Promoting Schools (AVHPS)

Ontario Health Insurance Plan.

 

- EBIC 1993.

- Ontario Health Insurance Program (OHIP).

- Ontario Health Insurance Plan (OHIP).

- EBIC 1993, 1998.

- NPHS, CCHS, Literature searches (RRs).

- EBIC.

Medical Services Insurance database

  

- Health expenditure from Health Canada.

- Discharge Abstract Database, Inpatient and Day Procedure.

  

- EBIC 2000.

 

.CIHI Discharge Abstract Database.

        

Nova Scotia Atlee Perinatal Database.

 

Number of comorbidities

 

8

10

  

8

22

18

  

Sample size

2,170

  

28,797

27,478

   

4,380

 

Perspective

Third-party payer

Societal

Societal

provincial health system

third-party payer

Societal

Societal

Societal

Provincial health care system.

Program manager

Direct Costs

Physician Costs

hospital care, specialized treatment, physician care, prescription drugs, and additional direct health expenditures

Hospital care, physician services, services of other health professionals, drugs, other health care and health research.

DAD-IP: costs of inpatient hospital stays.

Physician

hospital care expenditures, drug expenditures, physician care expenditures, costs for care in other institutions, and additional direct health expenditures

Hospital care, drugs, physician care, institutional care, and additional direct costs such as capital investments, public health, and research.

Hospital care, physician services, services provided by other health professionals, drugs, health research and other health care

MSI: physician (incl. emergency room visits) Aggregate costs of health care episodes for physician (birth-2006) visits and hospitalizations (2003-2006)

 

DAD-DP: costs of day procedures.

 

OHIP: physicians and nonhospital Laboratories costs.

 

Indirect costs

 

Mortality costs, morbidity costs due to long and short-term disability.

   

Mortality costs, morbidity costs due to long and short-term disability

Morbidity costs due to long and short-term disability.

Morbidity costs due to long and short-term disability.

  

Strengths/ Limitations in Costs Estimates

Insufficient direct costs and indirect costs.

Not available.

Indirect cost excluded.

Drug costs, costs associated with other non-physician healthcare providers or indirect costs were not included..

Insufficient direct costs (only physician cost). Indirect costs were not included.

Both direct and indirect costs included.

Excluded costs:

Meta-analysis of relative risks of chronic conditions.

Lack of drug prescription costs.

Donations, volunteers contribution were not fully recorded and costed.

 

Direct measures at individual level.

Direct measures at individual level

 

Meta-analysis of relative risks of chronic conditions

Out-of-pocket costs not reimbursed, morbidity costs.

 

Direct measures at individual level.

 
 

Self-reported BMI

 

Self-reported BMI.

Self-reported BMI.

Self-reported BMI

Measured BMI.

Measured BMI.

Measured BMI.

Measured BMI.

 
    

Overweight (BMI>=25) – 35 %

Adults – Overweight – 35. 85%

Obese (BMI>=30) - 14.7%

Overweight (BMI>=25) - 35.7%

Overweight (BMI>=25)

Overweight (BMI>=25) – 23%

 

Obesity measures and prevalence

Overweight and Obese - 58.6%

Not stated.

Obese (BMI>=27) – 13.5%

Obese (BMI>=30) - 17%

Obese – 16.95%Adolescents - Overweight –

 

Obese (BMI>=30) - 25.2%;

Obese (BMI>=30).

Obese (BMI>=30) - 10%

 
    

15%Obese – 5.3%

     

Results

$65 M

The total direct cost of obesity in Canada in 1997 was estimated to be between $2.1 billion to $11 billion (or between $64.4 and $343.4 per capita) ~ 2.4% to 12% of the total health care expenditures.

Total direct cost: $1.8 B (0.8-3.5 B) ~2.4% of the total direct health care expenditures in Canada in 1997.

One year total physician, hospitalization, day procedure costs: Normal: $708.0 ($668.2, $752.4)

Adults: Overweight: Male: 427 (397, 457) $/y, Female: 578 (542, 613) $/y ; Obese: Male: 475 (434, 518) $/y, Female: 682 (639, 736) $/y.

Physical inactivity (2.6% total health care costs in Canada): Total: $5.3 B; Direct: $1.6 B; Indirect: $3.7 B

Total $1.27 B.

Direct Costs - $ 6.0 B (65.7% attributable to Obesity) ~ 4.1% of the total direct health expenditures in Canada in 2006.

Population: 295 (133; 629); Normal weight: 275 (128; 598); Overweight: 298 (136; 600); Obese: 356 (140; 721).

The annual public funding to AVHPS to implement and maintain CSH totaled $344,514, which translates, on average, to $7,830 per school and $22.67 per student

The mean per capita cost of physicians' services in Ontario increased by $8.90 (95% CI: $1.90-$15.60) for each unit increase in BMI

Underweight: $746.0 ($652.0,

Adolescents: Comparable for normal-weight and overweight/ obese ($233/ y)

Obesity (2.2% total health care costs in Canada): Total: $4.3 B; Direct: $1.6 B; Indirect: $2.7 B.

Direct cost: $630.1M

Indirect Costs - $5.0 B ~4.2% total health expenditure in Canada in 2006.

Lifetime physician cost: Population: 2201 (1 449; 3 370) ; Normal weight: 2147 (1 428; 3 297) ; Overweight: 2309 (1 463; 3 315) ; Obese: 2504 (1 694; 3 725)

Indirect cost: $643.8M

    

Overweight: $690.3 ($648.2, $736.4)

      
    

Obesity: $884.1 ($806.1, $953.8)

     Â