The Impact of Severe Obesity on Healthcare Resource Utilisation in Spain

Espallardo, O.; Busutil, R.; Torres, Antonio; Zozaya, Néboa; Villoro, Renata; Hidalgo, Álvaro

doi:10.1007/s11695-017-2596-7

Cited by 14 publications

(13 citation statements)

References 37 publications

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“…Our results concerning the visiting rate of obese participants in the Emergency Department seems to confirm what has been described in other contexts. Obese individuals have a higher level of healthcare utilization [ 11 , 13 , 33 , 34 ]. A review from Kent et al analysed 75 studies and concluded that obese individuals had a mean increase of annual healthcare costs of 36%, compared to normal-weight individuals.…”

Section: Discussionmentioning

confidence: 99%

“…Bertakis et al did not find any differences in ED utilization between obese and normal-weight population. On the contrary, Espallardo et al found that ED utilization was higher for over class II obesity population but fail to take into account social variables throughout their analyses [ 25 , 34 ]. Other authors found a higher acute hospital admission rate and longer length-of-stay [ 26 , 33 ] but did not incorporate socio-economic status in the analysis.…”

Section: Discussionmentioning

confidence: 99%

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Obesity and emergency care in the French CONSTANCES cohort

et al. 2018

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ContextObese patients are raising specific questions in emergency care such as equipment issues or urgent procedures. Even though obesity prevalence and subsequent health expenditure are increasing worldwide, there is scarce literature about their specific resource utilization of Emergency Departments (ED). These few studies do not take into account both socio-economic situation and comorbidities which are well-known factors influencing healthcare use. Our objective was to assess the emergency care resource utilization of obese individuals (Body Mass Index (BMI) ≥ 30kg.m-2) compared to normal-weight individuals taking into account comorbidities and social-economic situations.MethodsThe French CONSTANCES epidemiologic cohort is a randomly selected sample of French adults. Participants data are linked to the National Health Insurance Database collecting all medical acts. The rate of ED visits of obese (and each obesity class) and normal-weight participants were compared considering confounding factors (comorbidities, various socio-economic data). The primary endpoint was to have visited the ED between 2010 and 2013. Sex-separated analysis and multivariate logistic regression models were performed and adjusted odds-ratios [OR] (95% Confidence Intervals [CI]) were calculated.ResultsWe included 21,035 normal-weight and 5,003 obese participants. Obese participants visited the ED more often than normal-weight participants (men: 30.5% vs. 26.7%; women: 30.3% vs. 24.4%, P<0.001). Obese participants presented more comorbidities and a lower socio-economic situation than normal-weight participants. After adjustment, obese participants had a higher risk of visiting ED (men: OR = 1.18; 95% CI: 1.04–1.33; and women: OR = 1.36; 95% CI: 1.22–1.52), with a higher risk for class III participants (BMI ≥ 40 kg.m-2) (men: OR = 2.18; CI 95%: 1.32–3.63; and women: OR = 1.85; 95% CI: 1.38–2.49).ConclusionObese individuals have a higher level of emergency care resource utilization than normal-weight individuals and it increases with severe obesity. Further studies are needed to better understand their healthcare pathways leading to EDs.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Obesity and emergency care in the French CONSTANCES cohort

et al. 2018

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“…Among high-income countries, people with obesity have ~30% more medical costs than people with normal weight ( 6 ). Similarly, adults living in Spain with a body mass index (BMI) ≥35 kg/m 2 use approximately twice as many primary care, home care, and psychology visits than adults with a normal BMI ( 7 ). In the United States (US), a country in which the healthcare system is based mainly on private insurance and out-of-pocket payments, the estimated yearly cost of medical visits, prescription drugs, or home care visits related to obesity is $149.4 billion ( 8 ).…”

Section: Introductionmentioning

confidence: 99%

Consideration of Social Disadvantages for Understanding and Preventing Obesity in Children

Ayala-Marín

Iguacel

Miguel-Etayo

et al. 2020

Front. Public Health

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Addressing social disadvantages that lead to obesity should be a public health priority. Obesity prevalence among children and adolescents has reached a plateau in countries with high income but it continues rising in low-income and middle-income countries. In high-income countries, an elevated prevalence of obesity is found among racial and ethnic minority groups and individuals from disadvantaged socioeconomic backgrounds. In addition to classic socioeconomic status (SES) factors, like income, parental education, and occupation, recent publications have linked parental social disadvantages, such as minimal social network, non-traditional family structure, migrant status and unemployment, with obesogenic behaviors and obesity among children. Socio-ecological models of obesity in children can explain the influence of classic SES factors, social disadvantages, culture, and genes on behaviors that could lead to obesity, contributing to the elevated prevalence of obesity. Obesity is a multifactorial disease in which multilevel interventions seem to be the most effective approach to prevent obesity in children, but previous meta-analyses have found that multilevel interventions had poor or inconsistent results. Despite these results, some multilevel interventions addressing specific disadvantaged social groups have shown beneficial effects on children's weight and energy balance-related behaviors, while other interventions have benefited children from both disadvantaged and non-disadvantaged backgrounds. Considering obesity as a worldwide problem, the World Health Organization, the European Commission, and the National Institutes of Health recommend the implementation of obesity prevention programs, but the implementation of such programs without taking into consideration social disadvantages may be an unsuccessful approach. Therefore, the present publication consists of a review of the pertinent literature related to social disadvantage and its consequences for behaviors that could lead to childhood obesity. In addition, we will discuss the relationship between social disadvantages and the socio-ecological model of obesity in children. Finally, we will summarize the relevant aspects of multilevel intervention programs aiming to prevent obesity in children and provide recommendations for future research and intervention approaches to improve weight status in children with social disadvantages.

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“…Entretanto, a necessidade de tratamento especializado para esse público, com abordagem multidisciplinar, e a importância do apoio da rede familiar e dos profissionais são aspectos que aparecem no discurso de vários autores entre os selecionados [14][15][16][17][18]20,22,23,24 .…”

Section: A Atenção Primária à Saúde E Atividades Em Grupo No Tratamenunclassified

“…Espallardo et al 15 , Jennings et al 20 e Booth et al 21 chamam a atenção para o fato de que a utilização de recursos de saúde aumenta com a gravidade do excesso de peso e obesidade quando comparada com outros grupos de IMC (maior pro-babilidade de ser hospitalizado ou exigir outros serviços de saúde, como laboratórios e exames de imagens) e ressaltam a importância das intervenções da atenção primária no objetivo de reduzir o peso e os agravos de saúde desses indivíduos além do enfrentamento da obesidade.…”

Section: A Atenção Primária à Saúde E Atividades Em Grupo No Tratamenunclassified

Educação em Saúde em Grupo no Tratamento de Obesos Grau III: um Desafio para os Profissionais de Saúde

Soeiro

Cortez

Mesquita

et al. 2019

Rev. bras. educ. med.

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RESUMO A obesidade tem se apresentado como sério problema de saúde pública mundial devido à magnitude que seus números alcançaram nos últimos anos. Diante do quadro de aumento do sobrepeso e obesidade no município do Rio de Janeiro, a Secretaria Municipal de Saúde do Rio de Janeiro (SMSRJ), com o apoio técnico do Instituto de Nutrição Annes Dias (INAD), implementou em julho de 2011 o primeiro Centro de Referência em Obesidade (CRO) no bairro de Acari. Este serviço oferece tratamento clínico ambulatorial para usuários com obesidade grau III (também conhecida como obesidade mórbida), com consultas individuais, assim como atendimentos em grupo, e também funciona como apoio especializado, contribuindo para ampliação da capacidade de atuação das equipes da Atenção Primária à Saúde (APS) com esse perfil de usuários através de uma equipe multiprofissional composta por educador físico, enfermeiro, médico endocrinologista, nutricionista e psicólogo. Neste contexto, a partir das experiências vivenciadas no CRO o objetivo do estudo é realizar uma revisão da literatura sobre a importância das atividades de educação em saúde em grupo no tratamento de indivíduos obesos grau III e como os profissionais de saúde tem lidado com esse tema nas publicações dos últimos 5 anos. Metodologia Trata-se de uma revisão integrativa da literatura, de acordo com a estratégia PICO (participantes, intervenção, contexto e resultados), cuja coleta dos dados foi realizada entre outubro e novembro de 2018, nas bases de dados Literatura Latino Americana e do Caribe em Ciências da Saúde (LILACS), Web of science, SciVerse Scopus, PUBMED e Bases de Dados em Enfermagem (BDENF). Resultados A partir da análise dos 11 artigos selecionados no estudo foi possível identificar três temáticas relevantes para a discussão: Rede de apoio aos usuários em tratamento, A Atenção primária à saúde e atividades em grupo no tratamento de obesos grau III, implementação de serviços especializados e qualificados no atendimento desse público. Conclusão As evidências mostram que a função da equipe de saúde em relação ao cuidado desse perfil de usuários vai além de orientações e informações e que o desenvolvimento e a implementação de serviços e/ou tratamentos voltados para obesos grau III constituem desafios significativos, e necessitam de profissionais qualificados na configuração de equipe multidisciplinar atuando de forma interdisciplinar que conscientizem o usuário a assumir o protagonismo de seu tratamento. E para isso, as atividades educativas em saúde em grupo, são ferramentas importantes para promoção de autonomia e compartilhamentos de experiências na busca por qualidade de vida relacionada à saúde.

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The Impact of Severe Obesity on Healthcare Resource Utilisation in Spain

Abstract: Severe obesity significantly increases healthcare resource utilisation in Spain. The results shed light on the real magnitude of the burden of obesity in Spain.

Cited by 14 publications

References 37 publications

Obesity and emergency care in the French CONSTANCES cohort

Obesity and emergency care in the French CONSTANCES cohort

Consideration of Social Disadvantages for Understanding and Preventing Obesity in Children

Educação em Saúde em Grupo no Tratamento de Obesos Grau III: um Desafio para os Profissionais de Saúde

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