The pandemic of obesity has a great impact on the health care system, and it accounts for an increasing ratio of health care expenses.
The aim of this study was to estimate the economic burden of ...overweight and obesity including both the health care budget and financial contribution of patients.
Data of the Hungarian National Health Insurance Fund were analyzed in the financial year of 2012. Expenses related to inpatient (hospital) and outpatient services and sick-leave finances related to obesity, diabetes and hypertension were analyzed. The incidence of obesity was calculated as high as 80% in diabetics and 60% in patients with hypertension.
According to this method of estimation, 207,000 million HUF (680 million EUR) was spent for treatment, which accounts for 11.6% of the total Hungarian health budget and corresponds to 0.73% of the gross domestic product. Additionally, at least 22,000 million HUF was paid by the patients as contribution to treatment. However, expenses related to overweight and obesity may be even higher considering a higher prevalence rate of overweight and obesity, and the occurrence of co-morbidities with higher costs (between 15% and 18% of the total health expenditure and at least 1% of the gross domestic product).
The results confirm that obesity- and overweight-related expenses represent a significant proportion of health care expenditure.
Obesity, a threatening pandemic, has an important public health implication. Before proper medication is available, primary care providers will have a distinguished role in prevention and management. ...Their performance may be influenced by many factors but their personal motivation is still an under-researched area.
The knowledge, attitudes and practice were reviewed in this questionnaire study involving a representative sample of 10% of all Hungarian family physicians. In different settings, 521 practitioners (448 GPs and 73 residents/vocational trainees) were questioned using a validated questionnaire.
The knowledge about multimorbidity, a main consequence of obesity was balanced.Only 51% of the GPs were aware of the diagnostic threshold for obesity; awareness being higher in cities (60%) and the highest among residents (90%). They also considered obesity an illness rather than an aesthetic issue.There were wider differences regarding attitudes and practice, influenced by the the doctors' age, gender, known BMI, previous qualification, less by working location.GPs with qualification in family medicine alone considered obesity management as higher professional satisfaction, compared to physicians who had previously other board qualification (77% vs 68%). They measured their patients' waist circumference and waist/hip ratio (72% vs 62%) more frequently, provided the obese with dietary advice more often, while this service was less frequent among capital-based doctors who accepted the self-reported body weight dates by patients more commonly. Similar reduced activity and weight-measurement in outdoor clothing were more typical among older doctors.Diagnosis based on BMI alone was the highest in cities (85%). Consultations were significantly shorter in practices with a higher number of enrolled patients and were longer by female providers who consulted longer with patients about the suspected causes of developing obesity (65% vs 44%) and offered dietary records for patients significantly more frequently (65% vs 52%). Most of the younger doctors agreed that obesity management was a primary care issue.Doctors in the normal BMI range were unanimous that they should be a model for their patients (94% vs 81%).
More education of primary care physicians, available practical guidelines and higher community involvement are needed to improve the obesity management in Hungary.
In Hungary, the last wide-range evaluation about nutritional status of the population was completed in 1988. Since then, only limited data were available. Our aim was to collect, analyze and present ...updated prevalence data.
Anthropometric, educational and morbidity data of persons above 18 y were registered in all geographical regions of Hungary, at primary care encounters and within community settings.
Data (BMI, waist circumference, educational level) of 40,331 individuals (16,544 men, 23,787 women) were analyzed. Overall prevalence for overweight was 40.4% among men, 31.3% among women, while for obesity 32.0% and 31.5%, respectively. Abdominal obesity was 37.1% in males, 60.9% in females. Among men, the prevalence of overweight-obesity was: under 35 y = 32.5%-16.2%, between 35-60 y = 40.6%-34.7%, over 60 y = 44.3%-36.7%. Among women, in the same age categories were: 17.8%-13.8%, 29.7%-29.0%, and 36.9%-39.0%. Data were presented according to age by decades as well. The highest odds ratio of overweight (OR: 1.079; 95% CI 1.026-1.135) was registered by middle educational level, the lowest odds ratio of obesity (OR: 0.500; 95% CI 0.463-0.539) by the highest educational level. The highest proportion of obese people lived in villages (35.4%) and in Budapest (28.9%). Distribution of overweighed persons were: Budapest (37.1%), other cities (35.8%), villages (33.8%). Registered metabolic morbidities were strongly correlated with BMIs and both were inversely related to the level of urbanization. Over the previous decades, there has been a shift in the distribution of population toward being overweight and moreover obese, it was most prominent among males, mainly in younger generation.
Evaluation covered 0.53% of the total population over 18 y and could be very close to the proper national representativeness. The threat of obesity and related morbidities require higher public awareness and interventions.
Correlations between obesity and asthma control in children: Hungarian primary care pilot study Introduction: Asthma is often associated with overweight and obesity. The aim of this study was to find ...associations between asthma control, obesity and different levels of physical activity. Methods: Using a questionnaire, 117 asthmatic patients between 6-18 years of age were interviewed. Two groups of children, normal vs. overweight, at different levels of physical activity (sport, school-based proper or light activity and full physical exemption) were compared. Asthma control was evaluated in two groups (controlled vs. non or partially controlled). Results: The asthmatic status was generally controlled in 78%; in 81% and 72% of patients with a normal weight and overweight, respectively. Being overweight was more common among girls than boys (43.2% vs. 30.3%). A positive family history of asthma was revealed in many cases; the prevalence of asthma was found at 63% (P=0.0074) among the parents. Weight was significantly higher when the parents themselves were overweight. A lightened workload in physical education lessons at school doubled the risk of obesity (P=0.25), while full exemption increased it by six times (P=0.06). High bodyweight was found in 37% and 31% of children who had received steroid medication and other treatment, respectively (P=0.57). Conclusion: High bodyweight and physical inactivity worsened the chances of effective asthma treatment, while sport improved it. The rates of physical activity among the surveyed patients were lower than recommended. More focus is needed; paediatricians, school-teachers and parents should pay more attention to the issue when establishing a proper family background for healthier lifestyles. PUBLICATION ABSTRACT
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