Body mass index and lifetime healthcare utilization

Abstract

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.

Modeling Obesity in Norway (The MOON Study): A Decision-Analytic Approach—Prevalence, Costs, and Years of Life Lost

“…40,[51][52][53][54][55][56] In addition, the patterns we identified align with previous research: that costs peak late in life (at 60-70 y old) 23,40,54 and are higher among women than men. 23,[53][54][55] Generally, cost estimates vary substantially between studies. 53 Since different studies use different data sources, it is hard to disentangle how much of this variation is caused by differences in the analytical frameworks applied or the populations under analysis.…”

Effectiveness and Safety of Rivaroxaban versus Warfarin Among Nonvalvular Atrial Fibrillation Patients with Obesity and Polypharmacy

“…The risk of stroke is increased fivefold in patients with nonvalvular AF (NVAF), and strokes are more likely to be severe in NVAF patients [2]. Obesity is a worsening public health crisis associated with serious health consequences, challenges for healthcare providers, and substantial economic burden [3][4][5]. The prevalence of adult obesity in the US was estimated at 42% in 2017-2018 and may approach 50% by 2030 [6][7][8].…”

Healthcare Resource Utilization and Costs of Rivaroxaban Versus Warfarin Among Nonvalvular Atrial Fibrillation Patients with Obesity and Diabetes

“…A recent study using the 2001-2016 Medical Expenditure Panel Survey found that total direct medical costs of obesity in US adults doubled from 2001 ($124.2 billion) to 2016 ($260.6 billion), and total annual medical expenditures of obese adults ($5010) were double those of people of normal weight ($2504) [17]. Overweight and obese individuals have increased utilization of primary and secondary healthcare services compared with those of normal body weight [2,17,18]. In addition, obese individuals are prescribed nearly twice as many medications and are nearly four times more likely to be hospitalized compared with nonobese individuals [2].…”