Hospital admissions associated with body mass index in Canadian adults

Chen, Yue; Jiang, Ying; Mao, Yang

doi:10.1038/sj.ijo.0803530

Cited by 31 publications

(25 citation statements)

References 41 publications

(41 reference statements)

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“…One such report [4] estimated that obesity accounted for up to 2.8% of healthcare expenditure globally but concluded that this was likely to be an underestimate. Although some studies have looked directly at the relationship between BMI and hospital admission rates [6-14], relatively few have considered duration of stay [6-8,10] and most have had insufficient power to assess reliably the relationship between BMI and less common causes of hospitalization.…”

Section: Introductionmentioning

confidence: 99%

Hospital admissions in relation to body mass index in UK women: a prospective cohort study

Reeves

Balkwill

Cairns

et al. 2014

BMC Med

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BackgroundAdiposity is associated with many adverse health outcomes but little direct evidence exists about its impact on the use of health care services. We aim to describe the relationship between body mass index (BMI) and rates of hospital admission in middle-aged UK women.MethodsAmong 1,251,619 Million Women Study participants, 50- to 64-years old at entry into the study, routine data on hospital admissions were used to estimate hospitalization rates according to BMI after standardization for age, region of recruitment, socioeconomic status, reproductive history, smoking status, hormonal therapy use and alcohol intake. Proportional hazards models were used to estimate adjusted relative risks of hospitalization separately for 25 common types of admission.ResultsDuring an average of 9.2 years follow-up, there were 2,834,016 incident hospital admissions. In women with BMIs (in kg/m2) of <22.5, 22.5 to <25, 25 to <30, 30 to <35 and 35+ standardized admission rates (and 95% confidence intervals (CIs)) per woman over a 10-year period were 2.4 (2.4 to 2.4), 2.4 (2.3 to 2.4), 2.6 (2.6 to 2.6), 3.0 (3.0 to 3.0) and 3.5 (3.4 to 3.5), respectively (P-value for heterogeneity <0.001). The relative increase in admission rates per 5 kg/m2 increase in BMI was 1.12 (1.12 to 1.13). This relationship did not vary materially by age. Corresponding average durations of stay (in days) per hospital visit within the same categories of BMI were: 3.1 (3.1 to 3.2), 2.8 (2.7 to 2.8), 2.9 (2.9 to 2.9), 3.2 (3.1 to 3.2) and 3.8 (3.7 to 3.8), respectively (P <0.001).Significant increases in the risk of admission with increasing BMI were observed for 19 of the 25 types of hospital admission considered. BMI was most strongly associated with admissions with diabetes, knee-replacement, gallbladder disease and venous thromboembolism, but marked associations were found with many other common categories of admission including cataracts, carpal tunnel syndrome and diverticulitis.ConclusionsAmong women 50- to 84-years old in England, around one in eight hospital admissions are likely to be attributable to overweight or obesity, translating to around 420,000 extra hospital admissions and two million extra days spent in hospital, annually.

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Section: Introductionmentioning

confidence: 99%

Hospital admissions in relation to body mass index in UK women: a prospective cohort study

Reeves

Balkwill

Cairns

et al. 2014

BMC Med

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“…Again, this study did not present any information on the medical characteristics and the HRQoL of this population, thus offering an incomplete picture of the burden of obesity in Ontario. While other Canadian studies have shown that obese individuals were more likely to have medical conditions, to report a worse HRQoL than normal-weight individuals and to consume more medical resources,5–7 these studies were limited as they did not include the elderly6 or all BMI categories (eg, overweight) 7. There is also a lack of data on the Canadian costs associated with being underweight 8…”

Section: Introductionmentioning

confidence: 99%

Health status, hospitalizations, day procedures, and physician costs associated with body mass index (BMI) levels in Ontario, Canada

Tarride¹,

Haq²,

Taylor³

et al. 2012

CEOR

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BackgroundObesity is today’s principal neglected public health problem, as a rising proportion of adults will succumb to the medical complications of obesity. However, little is known about the burden of obesity in adults living in Ontario.ObjectivesTo present an overview of the human and economic burden associated with BMI categories in Ontario, Canada, in terms of socio-demographics, comorbidities, health-related quality of life (HRQoL) and costs associated with hospitalization, same day procedures and physician visits.MethodsThe records of all Ontarians who participated in the Canadian Community Health Survey (CCHS), cycle 1.1 and provided consent to data linkage were linked to three administrative databases. Socio-demographic variables, medical characteristics, HRQoL, one year hospitalization, day procedure and physician costs were described per BMI category. Regression analyses were conducted to identify predictors of medical characteristics, HRQoL and costs.ResultsMore than 50% of adult participants were either overweight or obese in 2000/2001. Obese adults, and to a lesser extent overweight adults, were more likely to report physician-diagnosed comorbid conditions, to use medications, and to have a lower HRQoL. After covariate adjustment, the hospitalization and physician costs were respectively 40% and 22% higher among obese and overweight adults than among normal-weight adults. No statistical cost differences were observed between normal and underweight individuals or between normal and overweight individuals. HRQoL was significantly lower in underweight and obese adults when compared to normal-weight individuals.ConclusionsDue to the large human and economic burden associated with under- or excess-weight, policies promoting healthy weight should remain a priority for governments and employers.

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“…Results have been mixed, with some studies finding positive associations between obesity and hospital admissions7–9,11–13,15,16,18,19 and others finding no association10,14 or negative association. 17 Studies measured the effect of obesity on the risk of hospitalizations,7,9,10,12–14,17,18 length of hospital stay,8,9,11,16,19 or avoidable risk of hospitalizations and stays 15. Only three studies measured the effect of obesity on the number of hospitalizations 9,11,16…”

Section: Introductionmentioning

confidence: 99%

Impact of overweight and obesity on hospitalization: race and gender differences

et al. 2009

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Objective: To examine associations between weight status and number of all-cause and cause-specific hospitalizations overall, and by race and gender. Design: Longitudinal cohort study. Subjects: White and black adults (n ¼ 15 355) from the Atherosclerosis Risk in Communities Study who were normal weight (body mass index: X18.5 to o25.0 kg m À2 ; n ¼ 4997), overweight (X25.0 to o30.0 kg m À2 ; n ¼ 6100), or obese (X30.0 kg m À2 ; n ¼ 4258) at baseline. Measurements: Information on hospitalizations was collected using community and cohort surveillance methods. Negative binomial models adjusted for race, gender, field center, age, physical activity, education level, smoking status, alcoholic beverage consumption and health insurance at baseline. Adjusted numbers of hospitalizations were calculated after setting covariates to the mean value (for continuous variables) or to the average distribution (for categorical variables) observed in the entire cohort and are expressed as the number of hospitalizations per 1000 adults followed over a period of 13 years. Results: The covariate-adjusted average number of all-cause hospitalizations was 1316 per 1000 normal weight, 1543 per 1000 overweight and 2025 per 1000 obese. Normal weight women had significantly fewer hospitalizations than normal weight men (1173 versus 1515 per 1000), but the increase associated with being obese on the number of all-cause hospitalizations was larger in women than men (791 versus 589 per 1000). There was no significant difference detected between the number of hospitalizations in normal weight whites and blacks, and the increase in hospitalizations with overweight or obesity was also not different. Effects of weight status on several primary causes of hospitalization differed by gender and race group. Conclusion: Our work suggests that obesity prevention may reduce hospitalizations, a major component of rising healthcare costs. The impact of successful obesity prevention is likely to be larger in women than in men, and similar in blacks and whites.

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Hospital admissions associated with body mass index in Canadian adults

Cited by 31 publications

References 41 publications

Hospital admissions in relation to body mass index in UK women: a prospective cohort study

Hospital admissions in relation to body mass index in UK women: a prospective cohort study

Health status, hospitalizations, day procedures, and physician costs associated with body mass index (BMI) levels in Ontario, Canada

Impact of overweight and obesity on hospitalization: race and gender differences

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