Obesity and healthcare resource utilization: results from Clinical Practice Research Database (CPRD)

Abstract

SummaryBackground/ObjectivesThe economic burden of obesity and type 2 diabetes (T2D) rises with increasing prevalence. This study estimates the association between obesity, healthcare resource utilization (HCRU) and associated costs in individuals with/without T2D.Subjects/MethodsThis observational cohort study used the United Kingdom Clinical Practice Research Datalink data. Between 1 January 2011 and 31 December 2015, total HCRU costs and individual component costs (hospitalizations, general practitioner contacts, prescriptions) were calculated for individuals linked to the Hospital Episodes Statistics database with/without T2D with normal weight, overweight, class I, II, III obesity.ResultsA total of 396,091 individuals were included. Increasing body mass index (BMI) was associated with increased HCRU costs. At each BMI category, costs were greater for individuals with than without T2D. Relative to normal BMI, increasing BMI was positively associated with increased HCRU costs, with similar magnitude regardless of T2D. The total HCRU cost for an individual with class III obesity was 1.4‐fold (£3,695) greater than for normal weight.ConclusionIn the United Kingdom, HCRU costs were positively associated with increasing BMI, irrespective of T2D status. The combination of T2D and obesity was associated with higher HCRU costs compared with individuals of the same BMI, without T2D. These findings suggest that prioritizing weight management programmes focused specifically on individuals with obesity and T2D may be more cost‐effective than for those with obesity alone.

A retrospective case‐control cohort analysis of comorbidity and health expenditure in hospitalized adults diagnosed with obesity utilizing ICD‐10 diagnostic coding

“…Additionally, in the 45 and Up Study , which involved 220 000 adults, compared to individuals with BMI 22.5 to <25 kg/m 2 , the rate of admission and days, as well as cost for severe obesity (BMI 40‐49.9 kg/m 2 ) was 1.64 to 2.54 and 1.77 to 2.15, respectively, with one in eight admissions attributable to overweight or obesity as were one in six hospital days 5 . Large UK data (over 396 000 individuals) echo similar findings, in individuals with BMI ≥40 kg/m 2 being associated with ×1.32 greater healthcare resource utilization then healthy weight individuals 6 and that these interestingly were comparable between US and UK populations 7 …”

Body mass index and risk of obesity‐related conditions in a cohort of 2.9 million people: Evidence from a UK primary care database

“…Recent studies using the CPRD have also highlighted the additional resource use incurred in populations who have T2D or cardiovascular disease in addition to obesity 32,33 . Although a sizable proportion of obesity‐related costs and resource use are known to be contributed by complications of the disease, 34,35 there is considerable variation in which conditions are included in overall cost estimation for obesity 36 .…”

“…Recent studies using the CPRD have also highlighted the additional resource use incurred in populations who have T2D or cardiovascular disease in addition to obesity. 32,33 Although a sizable proportion of obesity-related costs and resource use are known to be contributed by complications of the disease, 34,35 there is considerable variation in which conditions are included in overall cost estimation for obesity. 36 Therefore, as well as demonstrating the cost benefits to be gained by a reduction in obesity rates, 37 data quantifying the impact of BMI on the risk of chronic conditions are needed to generate reliable inputs for economic evaluations of obesity.…”

Obesity and responsibility: Is it time to rethink agency?

“…69,70 Ultimately as a result of policy makers failing to appropriately address the prevention and treatment of obesity due to this pervasive narrative, a massive rise in the associated costs has occurred. 71 5 | OBESITY, CHOICE, AND STIGMA As described above, hunger and satiety are phenomena we experience as conscious percepts generated via projections from subcortical brain centers, which have the ability to become dysregulated. The reason why many consider obesity to be a choice and thus struggle to consider it a disease may be, as Daniel Dennett describes, because "they have a particular personal authority about the nature of their own conscious experience that can trump any hypothesis they find unacceptable."…”