Body mass index and health service utilisation in the older population: results from The Irish Longitudinal Study on Ageing

Hugh, Sheena Mc; O’Neill, Ciarán; Browne, John; Kearney, Patricia M.

doi:10.1093/ageing/afu177

Cited by 15 publications

(23 citation statements)

References 19 publications

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Section: Discussionsupporting

confidence: 85%

“…The greater uptake of dietetic support observed in this study is consistent with other studies wherein those with class III obesity are more likely to engage with this type of service compared with other allied health supports. 23 Utilization of intensive interventions in isolation was rare, and the greatest proportion of clinically significant weight loss was observed when allied health and intensive interventions were combined. This is consistent with previous research where multidisciplinary approaches to behavioural interventions were shown to yield greater long-term weight loss and improvement in particular metabolic profiles in patients with comorbid obesity and T2DM.…”

Section: Service Utilizationmentioning

confidence: 99%

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Determining patient attendance, access to interventions and clinical outcomes in a publicly funded obesity programme: Results from the Canberra Obesity Management Service

Brightman¹,

Hsu

Dugdale

2019

Clinical Obesity

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Summary Multi‐disciplinary specialist services have a crucial role in the management of patients with obesity. As demand for these services increases, so too does the need to monitor individual service performance and compare outcomes across multiple sites. This paper reports on results from the publicly funded Canberra Obesity Management Service. A descriptive observational study was conducted on new patients who attended an initial medical review from July 2016 to June 2017. Baseline characteristics, comorbidities, attendance, service utilization and outcomes were collated until June 2018. Of the 162 patients identified, 64% continued to attend beyond initial medical review. Dietetics was the most commonly accessed allied health service, followed by exercise physiology and psychology. Very low‐energy diet was the most commonly trialled intensive intervention, followed by pharmacotherapy and bariatric surgery. Mean baseline weight for those who continued beyond initial medical review was 142.0 kg (SD 26.6 kg), with a mean weight change of −6.2 kg (SD 10.2 kg) and a mean change in percentage body weight of −5% (SD 7%). Clinically significant weight loss was achieved in 36% of these patients, with a further 47% achieving weight stabilization. Mean Depression, Anxiety and Stress Scale scores reduced from 8‐6‐8 to 7‐5‐5, and mean Epworth Sleepiness Scale scores decreased from 8/24 to 6/24. Polysomnography referrals were made for 37% of all new patients, 87% of whom were diagnosed with varying degrees of obstructive sleep apnoea. We present these findings in the hope that they may serve as an example for data collection, individual service monitoring and comparison across multiple obesity services.

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Section: Discussionsupporting

confidence: 85%

Section: Service Utilizationmentioning

confidence: 99%

Determining patient attendance, access to interventions and clinical outcomes in a publicly funded obesity programme: Results from the Canberra Obesity Management Service

Brightman¹,

Hsu

Dugdale

2019

Clinical Obesity

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“…The figures are lower for men, but nearly 80% in the groups aged 45–54 and 55–64 years had overweight and obesity. This can have implications for the delivery of health services since a large segment of the middle-aged and older adult population will be living with obesity, and obesity is associated with additional health impairments [13]. …”

Section: Discussionmentioning

confidence: 99%

Overweight and Obesity in the Russian Population: Prevalence in Adults and Association with Socioeconomic Parameters and Cardiovascular Risk Factors

et al. 2019

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Objective: To evaluate the prevalence and geographic distribution of overweight and obesity in Russian adults aged 25–64 years as well as the association between chronic risk factors and obesity. Methods: Data were obtained from the survey “Epidemiology of Cardiovascular Diseases and Its Risk Factors in Some Regions of the Russian Federation” (ESSE-RF). This is a large cross-sectional multicenter population-based study that included interviews and medical examination (anthropometry, blood pressure [BP] measurement, and laboratory analysis) applied in 2012–2014. Results: The sample included 20,190 adults (response rate 79.4%) aged 25–64 years. Approximately one third of participants (30.3%) had obesity and another third (34.3%) were classified as overweight. BMI increased with age in both sexes. The prevalence of obesity between regions ranged from 24.4 to 35.5%. Overweight and obesity levels decreased with higher education (men only). Overall obesity rates were higher in rural than urban populations, but rates of overweight were similar in rural and urban populations. Participants with obesity were more likely to have BP > 160/100 mm Hg (odds ratio > 2.0) and also > 140/90 mm Hg, raised blood glucose, and high triglycerides. Conclusion: The prevalence of overweight and obesity in Russian adults aged 25–64 years is not evenly distributed geographically, but it is comparable to that of other European countries. Individuals with obesity were also more likely to have indicators of poor cardiovascular and metabolic health.

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“…In addition obese adults may have physical and social difficulties which inhibit daily living and can also require social care [ 2 ]. Obesity thus has considerable health and social care cost implications [ 3 – 8 ]. These costs, coupled with the current high prevalence of obesity in the general population (25% of adults in England [ 9 ]) highlight a requirement for effective interventions targeted at obesity prevention and reduction [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

“…Local authorities are responsible for social care provision and are perceived to face a considerable cost burden from obesity-related social care costs but there are few published estimates of social care resource use or cost related to BMI levels. Previous studies have been conducted in the older adult populations of Ireland [ 8 ] and Europe [ 13 ]. There is also a lack of published data that directly link obesity with social care need [ 2 ] or enable a calculation of obesity-related social care costs.…”

Section: Introductionmentioning

confidence: 99%

Estimating the variation in need for community-based social care by body mass index in England and associated cost: population-based cross-sectional study

Copley

Cavill²,

Wolstenholme

et al. 2017

BMC Public Health

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BackgroundAdult obesity is linked to a greater need for social care because of its association with the development of long term conditions and because obese adults can have physical and social difficulties which inhibit daily living. Obesity thus has considerable social care cost implications but the magnitude of these costs is currently unknown. This paper outlines an approach to estimating obesity-related social care costs in adults aged over 65 in England.MethodsWe used univariable and multivariable logistic regression models to investigate the relation between the self-reported need for social care and potential determinants, including body mass index (BMI), using data from Health Survey for England. We combined these modelled estimates of need for social care with the mean hours of help received, conditional on receiving any help, to calculate the expected hours of social care received per adult by BMI.ResultsBMI is positively associated with self-reported need for social care. A one unit (ie 1 kg/m2) increase in BMI is on average associated with a 5% increase in the odds of need for help with social care (odds ratio 1.05, 95% CI 1.04 to 1.07) in an unadjusted model. Adjusting for long term illness and sociodemographic characteristics we estimate the annual cost of local authority funded care for those who receive it is £599 at a BMI of 23 but £1086 at a BMI of 40.ConclusionBMI is positively associated with self-reported need for social care after adjustment for sociodemographic factors and limiting long term illness. The increase in need for care with BMI gives rise to additional costs in social care provision which should be borne in mind when calculating the cost-effectiveness of interventions aimed at reducing obesity.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-017-4665-1) contains supplementary material, which is available to authorized users.

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Body mass index and health service utilisation in the older population: results from The Irish Longitudinal Study on Ageing

Abstract: given these costs and improvements in life expectancy, an increasingly obese older population presents new challenges for healthcare delivery.

Cited by 15 publications

References 19 publications

Determining patient attendance, access to interventions and clinical outcomes in a publicly funded obesity programme: Results from the Canberra Obesity Management Service

Determining patient attendance, access to interventions and clinical outcomes in a publicly funded obesity programme: Results from the Canberra Obesity Management Service

Overweight and Obesity in the Russian Population: Prevalence in Adults and Association with Socioeconomic Parameters and Cardiovascular Risk Factors

Estimating the variation in need for community-based social care by body mass index in England and associated cost: population-based cross-sectional study

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