Variations in healthcare costs by body mass index and obesity-related complications in a UK population: A retrospective open cohort study.

IF 5.4 2区医学 Q1 ENDOCRINOLOGY & METABOLISM Diabetes, Obesity & Metabolism Pub Date : 2024-08-19 DOI:10.1111/dom.15785

Jonathan Pearson-Stuttard, Sara Holloway, Kasper Sommer Matthiessen, Andrew Thompson, Silvia Capucci

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Abstract

Aims: To estimate healthcare resource utilization (HCRU) and healthcare costs by body mass index (BMI) in a UK cohort and to explore how this varied by defined BMI strata.

Materials and methods: This retrospective open cohort study used Discover, a linked primary and secondary electronic health records database covering 2.7 million individuals. Adults were stratified by BMI as: overweight (25-<30 kg/m²); obesity class I (30-<35 kg/m²); obesity class II (35-<40 kg/m²); or obesity class III (≥40 kg/m²). Cost data, comprising primary care, secondary care (inpatient admissions, outpatient appointments and emergency room visits) and prescriptions, were reported for 2015-2019.

Results: Overall, 1 008 101 individuals were overweight, 278 782 had obesity class I; 80 621 had obesity class II, and 42 642 had obesity class III. Healthcare costs and HCRU events per person per year increased over time (2015: £851-£1321 and 10.6-13.4 events; 2019: £1143-£1871 and 11.4-14.9 events), and were higher for each successive BMI group. Groups with chronic kidney disease or cardiovascular disease incurred particularly high costs. In 270 493 individuals with obesity in 2019, more than 72% of total healthcare costs were incurred by the highest cost quintile, which had a higher mean age and more obesity-related complications (ORCs) than lower cost quintiles.

Conclusions: The economic impact of obesity could be alleviated by weight management support based on unmet need, to limit the effects of BMI progression and ORC development.

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英国人口中按体重指数和肥胖相关并发症划分的医疗成本差异：一项回顾性开放队列研究。

目的：根据英国队列中的体重指数（BMI）估算医疗资源利用率（HCRU）和医疗成本，并探讨不同体重指数阶层的差异：这项回顾性开放队列研究使用的是 "发现"（Discover）数据库，这是一个链接的初级和二级电子健康记录数据库，覆盖 270 万人。成人按体重指数分为：超重（25-2）；肥胖 I 级（30-2）；肥胖 II 级（35-2）；或肥胖 III 级（≥40 kg/m2）。报告了2015-2019年的成本数据，包括初级保健、二级保健（住院、门诊和急诊就诊）和处方：总体而言，有 1 008 101 人超重，278 782 人属于肥胖 I 级；80 621 人属于肥胖 II 级，42 642 人属于肥胖 III 级。随着时间的推移，每人每年的医疗成本和HCRU事件也在增加（2015年：851英镑-1321英镑，10.6-13.4个事件；2019年：1143英镑-1871英镑，11.4-14.9个事件），而且每个连续的BMI组别都更高。患有慢性肾病或心血管疾病的人群花费尤其高。在2019年的270 493名肥胖症患者中，总医疗费用的72%以上由费用最高的五分位组承担，与费用较低的五分位组相比，该五分位组的平均年龄更高，肥胖相关并发症（ORCs）更多：结论：根据未满足的需求提供体重管理支持，可减轻肥胖症对经济的影响，从而限制体重指数（BMI）的增长和肥胖相关并发症（ORC）的发生。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Diabetes, Obesity & Metabolism 医学-内分泌学与代谢

CiteScore

10.90

自引率

6.90%

发文量

319

审稿时长

3-8 weeks

期刊介绍： Diabetes, Obesity and Metabolism is primarily a journal of clinical and experimental pharmacology and therapeutics covering the interrelated areas of diabetes, obesity and metabolism. The journal prioritises high-quality original research that reports on the effects of new or existing therapies, including dietary, exercise and lifestyle (non-pharmacological) interventions, in any aspect of metabolic and endocrine disease, either in humans or animal and cellular systems. ‘Metabolism’ may relate to lipids, bone and drug metabolism, or broader aspects of endocrine dysfunction. Preclinical pharmacology, pharmacokinetic studies, meta-analyses and those addressing drug safety and tolerability are also highly suitable for publication in this journal. Original research may be published as a main paper or as a research letter.