Health Services Use and Health Care Costs of Obese and Nonobese Individuals

Raebel, Marsha A.; Malone, Daniel C.; Conner, Douglas A.; Xu, Stanley; Porter, Julie A.; Lanty, Frances A.

doi:10.1001/archinte.164.19.2135

Cited by 210 publications

(164 citation statements)

References 27 publications

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“…36 In a retrospective study of 539 obese and 1225 non-obese persons, obese patients had more hospitalizations, prescription drugs, professional claims and outpatient visits. 37 In an earlier analysis of the 1994 National Population Health Survey (NPHS) data, obese people were found to be more likely to consult with physicians, to use more prescribed drugs and to require excess disability days. 38 Using the same NPHS data set, Chen et al 39 found no significant association between obesity and overall hospital admissions.…”

Section: Discussionmentioning

confidence: 99%

Hospital admissions associated with body mass index in Canadian adults

2007

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Objective: To examine the associations between excess weight and health-care utilization in general Canadian population. Design: A national survey with a multistage stratified sampling design. Subjects: A total of 113 603 adults 20 years of age or more in 2003. Measurements: Self-reported overnight stay as an in-patient during the past 12 months, length of stay, height and weight.Results: The 12-month cumulative incidence of being an in-patient was 6.6% for men and 10.4% for women, with the length of stay in median of 3 nights for the patients. The adjusted odds ratio for obesity associated with being an in-patient was 1.24 (95% confidence interval: 1.109, 1.40) for men and 1.25 (1.14, 1.37) for women. The association between obesity and being an in-patient was significant or marginally significant in all categories of length of stay with an exception of the '1 night' category for men. Underweight men and women had an increased risk of approximately 30%. Underweight was only significantly associated with being an in-patient with a stay of '47 nights' in both sexes, and only small proportion of participants were underweight. Obesity contributed slightly more than 4% of being an in-patient in the Canadian adults. The population attributable fraction was very small for underweight because of low proportion of cases in that category. Conclusion: Obesity burdens the universal health-care system in Canada.

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Section: Discussionmentioning

confidence: 99%

Hospital admissions associated with body mass index in Canadian adults

2007

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“…Given that sample sizes were sufficient to summarize total visit cost for patients presenting with lead damage in the inpatient setting, we calculated the total hospitalization cost by summing the amount paid to the hospital by the insurer plus coinsurance, copayments, and deductibles paid by the patient. Given the distribution of total hospitalization costs observed, we excluded from cost analyses 19 patients whose total costs fell into the top 5% of the cohort (greater than $73 573 for the PM cohort, $191 042 for ICD, and $296 320 for the CRT‐D cohort) 9, 10, 11, 12. We hypothesized that these patients may have had other major procedures besides just lead revision or repair, resulting in the extreme variance in cost.…”

Section: Methodsmentioning

confidence: 99%

Incidence and Costs Related to Lead Damage Occurring Within the First Year After a Cardiac Implantable Electronic Device Replacement Procedure

Nichols

Vose

Mittal

2016

JAHA

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BackgroundInadvertent damage to leads for transvenous pacemakers, implantable cardioverter‐defibrillators, and cardiac resynchronization therapy defibrillators is an important complication associated with generator‐replacement procedures. We sought to estimate the incidence and costs associated with transvenous lead damage following cardiac implantable electronic device replacement.Methods and ResultsUsing the Truven Health Analytics MarketScan Commercial Research Database, we identified health care claims between 2009 and 2013 for lead damage following generator replacement. Patients were identified by claims with a procedure code for cardiac implantable electronic device replacement and then evaluated for 1 year. All follow‐up visits for lead damage were identified, and incidence, risk factors, and hospitalization costs were determined. A total of 22 557 patients with pacemakers, 20 632 with implantable cardioverter‐defibrillators, and 2063 with cardiac resynchronization therapy defibrillators met selection criteria. Incidence of lead damage was 0.46% for pacemaker replacement, 1.27% for implantable cardioverter‐defibrillator replacement, and 1.94% for cardiac resynchronization therapy defibrillator replacement procedures (P<0.001). After adjusting for patient characteristics, patients with implantable cardioverter‐defibrillators and cardiac resynchronization therapy defibrillators demonstrated risk of lead damage that was, respectively, double (hazard ratio 2.00, 95% CI 1.57–2.55) and >2.5 times (hazard ratio 2.58, 95% CI 1.73–3.83) that of patients with pacemakers. Lead revision or repair procedures were associated with increased inpatient hospitalization costs (mean $19 959 for pacemaker, $24 885 for implantable cardioverter‐defibrillator, and $46 229 for cardiac resynchronization therapy defibrillator; P=0.048, Kruskal–Wallis test).ConclusionsThese findings establish the first objective assessment of the incidence, risk factors, and economic burden of lead damage following cardiac implantable electronic device replacement in the United States. New care algorithms are warranted to avoid these events, which impose substantial burdens on patients, physicians, and payors.

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“…Several studies have shown that overweight and obesity are associated with increased drug use. [9][10][11][12][13][14][15] Much less information is available on the relation between physical activity levels and use of prescription drugs.…”

Section: Introductionmentioning

confidence: 99%

Relation between body mass index, physical inactivity and use of prescription drugs: the Doetinchem Cohort Study

et al. 2010

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Background: Obesity and physical inactivity are associated with several diseases such as diabetes, cardiovascular diseases, musculoskeletal complaints, osteoporosis, certain types of cancer and depression. However, few data are available on the specific types of medication associated with obesity and physical inactivity. Objective: The aim of this study was to determine the independent association of body mass index (BMI) and physical inactivity with use of specific classes of prescription drugs, and the interaction between BMI and physical inactivity. Methods: The Doetinchem Cohort Study is a population-based longitudinal study. We analyzed cross-sectional data of 1703 men and 1841 women, examined between 1998 and 2002, for whom drug-dispending data were available from the PHARMO database. Drugs were coded according to the WHO Anatomical Therapeutic Chemical (ATC) classification system. Body weight was measured during the physical examination. Physical activity was assessed using an extensive questionnaire. Persons were defined as a user of a certain drug class if they filed at least one prescription in the year around ( ± 6 months) the examination. Results: Compared with normal weight persons (BMI 18.5-25 kg m À2 ), obese persons (BMI430 kg m À2 ) had a higher use of prescription drugs of several drug classes, especially cardiovascular drugs (OR (95% CI): 3.83 (2.61-5.64) in men and 2.80 (2.03-3.86) in women) and diabetes drugs (OR (95% CI): 5.72 (2.32-14.14) in men and 3.92 (1.80-8.54) in women). In women, physical inactivity was also associated with higher use of certain drug classes, such as drugs for blood and bloodforming organs (OR (95% CI): 2.11 (1.22-3.65)) and musculoskeletal drugs (OR (95% CI): 2.07 (1.45-2.97)), whereas in men this was not the case. We found no interaction between BMI and physical inactivity with respect to use of prescription drugs. Conclusion: In both men and women, obesity was associated with a higher use of several types of prescription drugs, whereas physical inactivity was only associated with a higher use of certain drug classes in women.

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Health Services Use and Health Care Costs of Obese and Nonobese Individuals

Abstract: Over 1 year, health care costs for obese persons are higher than for nonobese persons, primarily because of prescription drugs.

Cited by 210 publications

References 27 publications

Hospital admissions associated with body mass index in Canadian adults

Hospital admissions associated with body mass index in Canadian adults

Incidence and Costs Related to Lead Damage Occurring Within the First Year After a Cardiac Implantable Electronic Device Replacement Procedure

Relation between body mass index, physical inactivity and use of prescription drugs: the Doetinchem Cohort Study

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