Obesity, cardiovascular risk and healthcare resource utilization in the UK

Abstract

Aims Obesity and cardiovascular diseases (CVDs) often co-occur, likely increasing the intensity of healthcare resource utilization (HCRU). This retrospective, observational database study examined the joint effect of obesity and cardiovascular risk status on HCRU and compared HCRU between body mass index (BMI) categories and CVD-risk categories in the UK. Methods Patient demographics and data on CVD and BMI were obtained from the UK Clinical Practice Research Datalink. Cardiovascular risk status, calculated using the Framingham Risk Equation, was used to categorize people into high-risk and low-risk groups, while a CVD diagnosis was used to define the established CVD group. Patients were split into BMI categories using the standard World Health Organization classifications. For each CVD and BMI category, mean number and costs of general practitioner contacts, hospital admissions and prescriptions were estimated. Results The final study population included 1,600,709 patients. Data on CVD status were available on just over one-quarter of the sample (28.6%) and BMI data for just less than half (43.2%). The number of general practitioner contacts and prescriptions increased with increasing BMI category for each of the three CVD-risk groups. The group with established CVD had the greatest utilization of all components of healthcare resource, followed by high CVD risk then low CVD-risk groups. Conclusion Increasing BMI category and CVD-risk status both affected several HCRU components. These findings highlight the importance of timely obesity management and treatment of CVD-risk factors as a means of preventing increasing HCRU.

Obesity and cardiovascular risk management is a critical way to reduce healthcare resource pressure

“…Evidence-based interventions aiming at healthcare cost containment are urgently needed. The present study by le Roux et al 4 is valuable as the authors identified obesity and CVD risk as two independent contributors to healthcare resource utilization and even provide accurate estimations of the additional costs resulted from obesity and CVD risk. The decision-makers will benefit from these findings when investing the limited resources to contain healthcare costs.…”

“…Considering the growing burden from obesity and CVD, 7,8 urgent strategies should be implemented. Although there were several limitations in the study by le Roux et al, 4 including a large proportion of patients with missing BMI data and without considering some important factors in the analysis, such as socioeconomic status, the present study still adds to the evidence of obesity management being essential to reduce healthcare costs. Unhealthy lifestyle is a major modifiable risk factor in obesity and the CVD population.…”

“…The article by le Roux et al 4 published in this issue of the European Journal of Preventive Cardiology offers a targeted approach to this question. The authors found a consistently increasing trend in healthcare resource utilization related to CVD risk in each body mass index (BMI) group, and also a consistently increasing trend in healthcare resource utilization related to BMI in each CVD risk group.…”

“…However, an accurate estimation of the cost resulted from obesity or CVD is lacking. Le Roux et al, 4 for the first time, present the variations in healthcare costs associated with obesity and CVD risk in a large representative population of the UK. Moreover, this study sourced cost data directly from the Nation Health Service, which is much more accurate, as opposed to insurance claims databases that often underestimate medical costs.…”

“…Moreover, this study sourced cost data directly from the Nation Health Service, which is much more accurate, as opposed to insurance claims databases that often underestimate medical costs. Le Roux et al 4 reported that among the population with low CVD risk, the ones with BMI 40 kg/ m 2 would cost more than two times those with BMI between 18.5 and 25 kg/m 2 (£6047 vs. £2683). Similarly, among the population with BMI between 18.5 and 25 kg/m 2 , the ones with established CVD would more than double the cost of the ones with low CVD risk (£7394 vs. £2683).…”