Аннотация
Objective: To estimate the lifetime and cumulative direct medical burden associated with childhood overweight and obesity in Kazakhstan using a dynamic age-structured modeling approach. Methods: A dynamic age-structured Markov cohort model was developed to simulate the progression of children aged 5-9 years through successive age groups and weight states (normal weight, exclusive overweight, and obesity). Transition probabilities were reconstructed using a synthetic cohort approach based on repeated cross-sectional prevalence data and were calibrated to reproduce observed epidemiological patterns. State-specific annual direct medical costs were estimated using a normative costing approach based on national clinical protocols and tariffs. Lifetime burden was calculated as the discounted sum of future medical costs (3% discount rate). Furthermore, cumulative short-term was estimated for the period 2024-2035. Deterministic sensitivity analysis and structural scenario analysis were conducted to assess model robustness. Policy scenarios examined the impact of reducing childhood obesity prevalence by 5 and 10%. Results: The average discounted lifetime cost per child was 96,996.26 KZT (USD 206.37), resulting in a total national lifetime financial impact of 194 billion KZT (USD 413 million) for the 2024 cohort of children aged 5-9 years. Over the 2024-2035 horizon, cumulative discounted direct healthcare expenditure reached 128.72 billion KZT (USD 273.9 million), with approximately 71% attributable to obesity. Sensitivity analysis showed that model results were most responsive to parameters related to obesity prevalence and costs. Structural scenarios indicated that the base-case model likely underestimates cost, with age-varying adult costs increasing estimates by up to 13.6%. Policy scenarios demonstrated that a 5 and 10% reduction in childhood obesity prevalence could reduce lifetime burden by 4.8 and 9.4%, respectively. Conclusion: Childhood obesity imposes a substantial and persistent economic impact on Kazakhstan's healthcare system. Preventive interventions targeting obesity in early life may yield significant long-term cost savings and should be prioritized in national health policy.