Healthcare utilization associated with obesity management in Ontario, Canada.

Abstract

This study aimed to describe the characteristics, healthcare resources utilized and costs incurred by adults receiving publicly funded obesity care in Ontario, Canada. People living with obesity who first visited Wharton Medical Clinic, a weight and diabetes management clinic in Ontario, between 2015 and 2018 were identified. Pseudoanonymized data were linked to administrative databases to understand healthcare utilization and costs borne by the public payer over 3 years. 6208 participants had linked data, 63.9% and 27.3% of whom remained followed one and two years after their first clinic visit, respectively. The cohort was 71.84% female with a mean (SD) age of 50.86 (13.28) years and BMI of 40.21 (7.06) kg/m². Approximately 25% of participants were prescribed pharmacotherapy (liraglutide, orlistat, naltrexone/bupropion), 4% received psychological therapy and 2% had weight-loss surgery. Common obesity-related complications were hypertension (42.62%), musculoskeletal pain (35.20%) and dyslipidaemia (33.65%). Participants had 22.16 physician visits per person-year in year one, mostly to general practitioners and endocrinologists, which decreased to 17.38 visits per person-year by year three. Mean total costs (excluding privately covered prescriptions) per person-year decreased from $5227.25 (Canadian dollars) (SE: $0.97) to $4982.88 (SE: $2.16) over the same period. Participants were mostly female and presented with obesity-related complications. Although healthcare utilization and costs incurred by the cohort were high, both showed a decreasing trend over the follow-up period.