ABSTRACT
Background: The health associated costs of obesity can represent between 2 percent and 9 percent of the total health costs of a given country. Aim: To assess the impact of obesity on health care costs and absenteeism in a cohort of mine workers. Patients and wethods: Prospective study of 4.673 men, employees of a mining company, aged 49 ± 7 years that were followed for 24 ± 11 months. Total health care cost and days of sick leave were recordedfor each individual. The association between obesity and these variables was analyzed by logistic regression adjusting for co-morbidities, age and other variables. Results: Mean annual health care costs for obese workers were 17 percent higher (p <0.001) compared to workers with normal weight and 58 percent higher (p <0.001) for workers with severe and morbid obesity. Mean annual days of sick leave increased by 25 percento in the obese (p =0.002) and by 57 percento in subjects with severe and morbid obesity (p <0.001). For health care costs the most significant predictors were: presence of diabetes mellitus (Odds ratio (OR) 6.21, 95 percento confidence intervals (95 percent CI) 4.9 to 7.9), hypertension (OR 3-99; 95 percent CI3-4 to 4.6) and severe and morbid obesity (OR 2.55, 95 percento CI 1.9 to 3-4). For absenteeism the most significant predictors were: presence of diabetes mellitus (OR 1.58, 95 percent> CI 1.2 to 2.0), hypertension (OR 1,34, 95 percent> CI 1.2 to 1.6) and severe and morbid obesity (OR 1.50, 95 percento CI 1.1 to 2.1). Conclusions: Obesity increases significantly health care costs and absenteeism.
Subject(s)
Adult , Aged , Humans , Male , Middle Aged , Absenteeism , Health Care Costs/statistics & numerical data , Mining/statistics & numerical data , Obesity/economics , Occupational Diseases/economics , Body Mass Index , Chile/epidemiology , Cohort Studies , Comorbidity , Health Expenditures/statistics & numerical data , Nutritional Status , Obesity, Morbid/economics , Obesity/complications , Obesity/epidemiology , Occupational Diseases/epidemiology , Prevalence , Prospective StudiesABSTRACT
Se analiza la experiencia adquirida en 132 casos de embarazo ectópico atendidos en el Hospital Clínico Regional de Concepción entre el 1ª de enero de 1982 y el 30 de junio de 1984. La frecuencia observada fue de 1 por cada 113 partos; la edad promedio fue de 28,9 años, con una variación de 18 a 41 años. Entre los antecedentes causales de mayor frecuencia aparecen usuarias de dispositivo intrauterino, DIU; aborto, y cirugía tubaria y ovárica. Se detallan los hallazgos del examen físico y los métodos de ayuda diagnóstica. Entre estos últimos destacan la punción del fondo de saco de Douglas, la ecografía, la biopsia de endometrio, la celiotomía exploradora y la laparoscopia. El diagnóstico fue correcto y oportuno en 84,8% de los casos; se sospechó en 8,3%, e incorrecto en 6,8%. No hubo mortalidad materna. Se discuten y comentan los resultados, poniéndose de relieve la importancia de la observación y de la cuidadosa evaluación clínica de cada paciente