Body Mass Index Trajectories and Healthcare Utilization in Young and Middle-aged Adults

Elrashidi, Muhamad Y.; Jacobson, Debra J.; Sauver, Jennifer L. St.; Fan, Chun; Lynch, Brian; Rutten, Lila J. Finney; Ebbert, Jon O.

doi:10.1097/md.0000000000002467

“…For both males and females we found positive associations between overweight and obesity and the likelihood of primary care utilization. Most previous studies [6][7][8][9]12] have found positive associations between obesity and secondary care utilization, but a few do not find such an association [5,11]. Our results for secondary care utilization are varied, and differ between males and females.…”

Section: Discussioncontrasting

confidence: 77%

“…Non-lifetime studies have found associations between obesity and physician encounters [5][6][7][8][9][10][11], hospitalizations [7,8,12], and hospital outpatient visits [6,7,12], and specialist visits [9]. A few studies have not found significant associations between obesity and hospitalization [5,6,11] or find differing results depending on age [13], or gender [10].…”

Section: Introductionmentioning

confidence: 99%

Body mass index and lifetime healthcare utilization

Edwards

¹

,

Aas

²

,

Kinge

³

2019

Preprint

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Background: Overweight and obesity is a major global public health challenge, and understanding the implications for healthcare systems is essential for policy planning. Past studies have typically found positive associations between obesity and healthcare utilization, but these studies have not taken into consideration that obesity is also associated with early mortality. We examined associations between body mass index (BMI, reported as kg/m2) and healthcare utilization with and without taking BMI-specific survival into consideration. Methods: We used nationally representative data on 33 882 adults collected between 2002 and 2015. We computed BMI- and age-specific primary and secondary care utilization and multiplied the estimated values with gender-, age-, and BMI-specific probabilities of surviving to each age. Then, we summed the average BMI-specific utilization between 18 and 85 years. Results: During a survival-adjusted lifetime, males with normal weight (BMI: 18.5–24.9) had, on average, 167 primary care, and 77 secondary care contacts. In comparison, males with overweight (BMI: 25.0–29.9), category I obesity (BMI: 30.0–34.9), and category II/III obesity (BMI ≥35.0) had 11%, 41%, and 102% more primary care, and 14%, 29%, and 78% more secondary care contacts, respectively. Females with normal weight had, on average, 210 primary care contacts and 91 secondary care contacts. Females with overweight, category I obesity, and category II/III obesity had 20%, 34%, and 81% more primary care contacts, and 26%, 16%, and 16% more secondary care contacts, respectively. Conclusion: The positive association between BMI and healthcare utilization was reduced, but not offset, when BMI-specific survival was taken into consideration. Our findings underpin previous research and suggest that interventions to offset the increasing prevalence of overweight, and especially obesity, are warranted.

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“…For both males and females we found positive associations between overweight and obesity and the likelihood of primary care utilization. Most previous studies [6][7][8][9]12] have found positive Estimates were adjusted for age, education marital status, geographic region of residence, smoking status and study period associations between obesity and secondary care utilization, but a few do not find such an association [5,11]. Our results for secondary care utilization are varied, and differ between males and females.…”

Section: Discussioncontrasting

confidence: 71%

Body mass index and lifetime healthcare utilization

Edwards

¹

,

Aas

²

,

Kinge

³

2019

Preprint

0

View full text Add to dashboard Cite

Background: Overweight and obesity is a major global public health challenge, and understanding the implications for healthcare systems is essential for policy planning. Past studies have typically found positive associations between obesity and healthcare utilization, but these studies have not taken into consideration that obesity is also associated with early mortality. We examined associations between body mass index (BMI, reported as kg/m2) and healthcare utilization with and without taking BMI-specific survival into consideration. Methods: We used nationally representative data on 33 882 adults collected between 2002 and 2015. We computed BMI- and age-specific primary and secondary care utilization and multiplied the estimated values with gender-, age-, and BMI-specific probabilities of surviving to each age. Then, we summed the average BMI-specific utilization between 18 and 85 years. Results: During a survival-adjusted lifetime, males with normal weight (BMI: 18.5–24.9) had, on average, 167 primary care, and 77 secondary care contacts. In comparison, males with overweight (BMI: 25.0–29.9), category I obesity (BMI: 30.0–34.9), and category II/III obesity (BMI ≥35.0) had 11%, 41%, and 102% more primary care, and 14%, 29%, and 78% more secondary care contacts, respectively. Females with normal weight had, on average, 210 primary care contacts and 91 secondary care contacts. Females with overweight, category I obesity, and category II/III obesity had 20%, 34%, and 81% more primary care contacts, and 26%, 16%, and 16% more secondary care contacts, respectively. Conclusion: The positive association between BMI and healthcare utilization was reduced, but not offset, when BMI-specific survival was taken into consideration. Our findings underpin previous research and suggest that interventions to offset the increasing prevalence of overweight, and especially obesity, are warranted.

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“…Weight and height were measured using standardized procedures, and BMI was weight (kg) divided by squared height (m 2 ). 30 Blood pressure was measured three times using standardized conditions and validated devices. 31 Hypertension was defined as current blood pressure medication or mean systolic blood pressure ≥140 mmHg, 31,32 hypercholesterolemia as a previous diagnosis, total cholesterol >200 mg/dL or lipid-lowering treatment, and diabetes mellitus as fasting glucose ≥126 mg/dL or current treatment.…”

Section: Methodsmentioning

confidence: 99%