El trasfondo económico de las intervenciones sanitarias en la prevención de la obesidad

Revista Española de Salud Pública (Impact Factor: 0.71). 02/2009; 83(1). DOI: 10.1590/S1135-57272009000100003
Source: OAI


Aunque hay dificultades metodológicas, organizativas y económicas para evaluar el coste-efectividad de las políticas contra la obesidad, es necesario conocer la rentabilidad social de los recursos que la sociedad destina a afrontar la epidemia. Este artículo revisa de forma ordenada los argumentos económicos relacionados con dichas políticas, y presenta una revisión de la literatura sobre los costes macro de la enfermedad y sobre la efectividad y el coste-efectividad de las intervenciones individuales y comunitarias contra la obesidad.

  • Source
    • "En este sentido, debe tenerse en cuenta que el establecimiento de los seguros de salud lleva a conductas por parte de los individuos que involucran una tendencia al incremento de los costos en el sistema de salud que se suma a la que de por sí conlleva la mayor prevalencia de la obesidad y el sobrepeso, así como las enfermedades que se les asocian (Britos, 2007; Temporelli, 2010). Por otro lado, existen autores que sostienen que la obesidad puede ser " contagiosa " , lo que significa que aquellos individuos que conviven en ambientes donde predomina la obesidad, es decir, en entornos obesogénicos, presentan mayor tendencia a padecer la misma (Rodríguez y González, 2009). "
    [Show abstract] [Hide abstract]
    ABSTRACT: According to World Health Organization obesity has become a global epidemic. Its increasing prevalence is leading to a greater incidence of associated diseases, with a significant impact on health systems costs and a decline in life quality. The obesity has become a priority problem of public health. Market failures present in the sector is an argument that justifies government intervention. Based on this, is that the objective of this paper is to analyze market failures present in the sector and make a comprehensive compilation of public policies that have been proposed for the treatment and prevention of obesity.
    Preview · Article · Jun 2013
  • Source
    • "Today it is accepted that obesity has a multifactorial origin [4,5] and is a known risk factor for numerous health problems, including high cholesterol, diabetes, hypertension, respiratory problems, musculoskeletal diseases, cardiovascular diseases, and some forms of cancer. Mortality also increases sharply once the overweight threshold is crossed [6,7]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Background At present, scientific consensus exists on the multifactorial etiopatogenia of obesity. Both professionals and researchers agree that treatment must also have a multifactorial approach, including diet, physical activity, pharmacology and/or surgical treatment. These two last ones should be reserved for those cases of morbid obesities or in case of failure of the previous ones. The aim of the PRONAF study is to determine what type of exercise combined with caloric restriction is the most appropriate to be included in overweigth and obesity intervention programs, and the aim of this paper is to describe the design and the evaluation methods used to carry out the PRONAF study. Methods/design One-hundred nineteen overweight (46 males) and 120 obese (61 males) subjects aged 18–50 years were randomly assigned to a strength training group, an endurance training group, a combined strength + endurance training group or a diet and physical activity recommendations group. The intervention period was 22 weeks (in all cases 3 times/wk of training for 22 weeks and 2 weeks for pre and post evaluation). All subjects followed a hypocaloric diet (25-30% less energy intake than the daily energy expenditure estimated by accelerometry). 29–34% of the total energy intake came from fat, 14–20% from protein, and 50–55% from carbohydrates. The mayor outcome variables assesed were, biochemical and inflamatory markers, body composition, energy balance, physical fitness, nutritional habits, genetic profile and quality of life. 180 (75.3%) subjects finished the study, with a dropout rate of 24.7%. Dropout reasons included: personal reasons 17 (28.8%), low adherence to exercise 3 (5.1%), low adherence to diet 6 (10.2%), job change 6 (10.2%), and lost interest 27 (45.8%). Discussion Feasibility of the study has been proven, with a low dropout rate which corresponds to the estimated sample size. Transfer of knowledge is foreseen as a spin-off, in order that overweight and obese subjects can benefit from the results. The aim is to transfer it to sports centres. Effectiveness on individual health-related parameter in order to determine the most effective training programme will be analysed in forthcoming publications. Trial registration NCT01116856
    Full-text · Article · Dec 2012 · BMC Public Health
  • Source
    • "A diferencia de la epidemiología o de un enfoque " salubrista " , la economía de la salud tiene como uno de los desafíos más relevantes estimar el impacto económico de determinada enfermedad a corto y largo plazo, el cual incluye costos directos como los atribuibles al tratamiento del problema médico y las enfermedades asociadas, e indirectos como la pérdida de oportunidades educativas, mayores costos laborales, costos de prevención, gastos de seguridad social, etc., todos los cuales son impedimentos para el desarrollo de un país (Gardner y Halweil, 2000; Rosin, 2008; Rodríguez Caro y González López-Valcárcel, 2009). "
    [Show abstract] [Hide abstract]
    ABSTRACT: This is a study of obesity socio-economic determinants, as well as its impact on older aldults hypertension prevalence in Montevideo, Uruguay, the country with the eldest population of the southern hemisphere. Through the use of the Health, Well-being and Ageing survey (SABE project, PAHO-WHO, 2001) we estimate separate Instrumental Variables Probit models for women and men, and with respect to two alternative measures of obesity: body mass index (BMI) and waist measure. Coinciding with the epidemiological literature, our results show the importance of an accurate diagnosis and differential treatment by sex. For men, we confirm the presence of endogeneity in the estimations of obesity and hypertension, suggesting the existence unobservable factors that determine both outcomes at the same time. In the case of not taking into account this potential endogeneity, a standard probit model results in an important subestimation of the negative effect of obesity in the probability of suffering from hypertension. First stage results show the relevance and validity of the instruments used (eating habits and social capital). In particular, social capital represents a positive externality by reducing the probability of being obese. This could be the result of common rules and beliefs, as source of support or of spread of healthy habits. At the same time, we find that obesity problems are concentrated among the most favoured social groups (in the present and in the first years of life). This brings some scepticism about the effectiveness of price policies favouring the idea of specific age group orientated interventions.
    Full-text · Article · Sep 2009 · Desarrollo y sociedad
Show more