Evidence map›Paper›PMID 39574122›Full record

ArticleBMC medicine2024

Economic costs attributable to modifiable risk factors: an analysis of 24 million urban residents in China.

Xuechen Xiong, Zhaohua Huo, Yinan Zhou, David M Bishai, Karen A Grépin, Philip M Clarke, Cynthia Chen, Li Luo, Jianchao Quan

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In one paragraph

Article in BMC medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
  4. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Xuechen XiongSchool of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.
Zhaohua HuoDepartment of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China.
Yinan ZhouSchool of Public Health, Fudan University, Shanghai, China.
David M BishaiSchool of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.
Karen A GrépinSchool of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.
Philip M ClarkeHealth Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
Cynthia ChenSaw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.
Li Luo *School of Public Health, Fudan University, Shanghai, China.
Jianchao Quan *School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China. jquan@hku.hk.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundEstimating the economic burden of modifiable risk factors is crucial for allocating scarce healthcare resources to improve population health. We quantified the economic burden attributable to modifiable risk factors in an urban area of China.

methodsOur Shanghai Municipal Health Commission dataset covered 2.2 million inpatient admissions for adults (age ≥ 20) in public and private hospitals in 2015 (1,327,187 admissions) and 2020 (837,482 admissions). We used a prevalence-based cost-of-illness approach by applying population attributable fraction (PAF) estimates for each modifiable risk factor from the Global Burden of Diseases Study (GBD) to estimate attributable costs. We adopted a societal perspective for cost estimates, comprising direct healthcare costs and productivity losses from absenteeism and premature mortality. Future costs were discounted at 3% and adjusted to 2020 prices.

resultsIn 2020, the total societal cost attributable to modifiable risk factors in Shanghai was US$7.9 billion (95% uncertainty interval [UI]: 4.6-12.4b), mostly from productivity losses (67.9%). Two health conditions constituted most of the attributable societal cost: cancer (51.6% [30.2-60.2]) and cardiovascular disease (31.2% [24.6-50.7]). Three modifiable risk factors accounted for half of the total attributable societal cost: tobacco (23.7% [16.4-30.5]), alcohol (13.3% [8.2-19.7]), and dietary risks (12.2% [7.5-17.7]). The economic burden varied by age and sex; most of the societal costs were from males (77.7%), primarily driven by their tobacco and alcohol use. The largest contributor to societal costs was alcohol for age 20-44, and tobacco for age 45 + . Despite the COVID-19 pandemic, the pattern of major modifiable risk factors remained stable from 2015 to 2020 albeit with notable increases in attributable healthcare costs from cancers and productivity losses from cardiovascular diseases.

conclusionsThe substantial economic burden of diseases attributable to modifiable risk factors necessitates targeted policy interventions. Priority areas are reducing tobacco and alcohol consumption and improving dietary habits that together constitute half of the total attributable costs. Tailored interventions targeting specific age and sex groups are crucial; namely tobacco in middle-aged/older males and alcohol in younger males.

Indexed as

Cost of IllnessHealth Care CostsAdultAgedAged, 80 and overCardiovascular DiseasesChinaFemaleHumansMaleMiddle AgedPrevalenceRisk FactorsUrban PopulationYoung AdultHealthcare costModifiable risk factorsProductivity lossSocietal costUrban China

Identifiers

PMID39574122
PMCPMC11580671

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.