Healthcare costs attributable to abnormal weight in China: evidence based on a longitudinal study

Abstract

Background The prevalence of abnormal weight is on the rise, presenting serious health risks and socioeconomic problems. Nonetheless, there is a lack of consensus on the medical cost savings that can be attained through the mitigation of abnormal weight. The aim of this study was to estimate the impact of abnormal weight on health care costs in China. Methods The study employed a 5-wave panel data from China Family Panel Studies (CFPS) between 2012 and 2020 (8,847 participants in each wave). Inpatient, non-inpatient and total healthcare costs were outcome variables. Abnormal weight is categorized based on body mass index (BMI).Initially, the two-part model was employed to investigate the impact of overweight/obesity and underweight on healthcare utilisation and costs, respectively. Subsequently, the estimated results were utilised to calculate the overweight/obesity attributable fraction (OAF) and the underweight attributable fraction (UAF). Results In 2020, the total national healthcare cost of the overweight and obese population was estimated to be $189.99 billion and $ 62.54 billion, and the underweight population was $37.32 billion. In comparison to people of normal weight, individuals who were overweight/obese (OR=1.072, p<0.05) and underweight (OR=1.143, p<0.1) were more likely to utilise healthcare services. Overweight/obesity attributable fraction (OAF) was 3.16% of total healthcare costs and 2.80% of non-inpatient costs. Underweight attributable faction (UAF) was 2.10% of total healthcare costs and 1.92% of non-inpatient costs. Both overweight/obese and underweight increased the likelihood of hospitalisation, although neither of them had a statistically significant impact on inpatient costs (p>0.1). Conclusions Abnormal weight imposes a huge economic burden on individuals, households and the society. Abnormal weight in Chinese adults significantly increased healthcare utilisation and costs, particular in non-inpatient care. It is recommended that government and relevant social agencies provide a better social environment to enhance individual self-perception and promote healthy weight.