体重指数与未来医疗保健成本：一项回顾性队列研究。

Body mass index and future healthcare costs: a retrospective cohort study.

作者信息

Thompson D, Brown J B, Nichols G A, Elmer P J, Oster G

机构信息

Policy Analysis Inc. (PAI), Brookline, Massachusetts 02445, USA.

出版信息

Obes Res. 2001 Mar;9(3):210-8. doi: 10.1038/oby.2001.23.

DOI:10.1038/oby.2001.23

PMID:11323447

Abstract

OBJECTIVE

To assess the relationship between body mass index (BMI) and future healthcare costs.

RESEARCH METHODS AND PROCEDURES

We undertook a retrospective cohort study of the relationship between obesity and future healthcare costs at Kaiser Permanente Northwest Division, a large health maintenance organization in Portland, Oregon. Study subjects (n = 1286) consisted of persons who responded to a 1990 health survey that was mailed to a random sample of adult Kaiser Permanente Northwest Division members who were 35 to 64 years of age; had a BMI > or = 20 kg/m(2) (based on self-reported height and weight); did not smoke cigarettes; and did not have a history of coronary heart disease, stroke, human immunodeficiency virus, or cancer. Subjects were stratified according to their BMI in 1990 (20 to 24.9, 25 to 29.9, and > or = 30 kg/m(2); n = 545, 474, and 367, respectively). We then tallied their costs (in 1998 US dollars) for all inpatient care, outpatient services, and prescription drugs over a 9-year period (1990 through 1998).

RESULTS

For persons with BMIs of 20 to 24.9 kg/m(2), mean (+/-SE) annual costs of prescription drugs, outpatient services, inpatient care, and all medical care averaged $261 (+/-18), $848 (+/-59), $532 (+/-85), and $1631 (+/-120), respectively, over the study period. Cost ratios (95% confidence intervals) for persons with BMIs of 25 to 29.9 kg/m(2) and > or = 30 kg/m(2), respectively, were 1.37 (1.12 to 1.66) and 2.05 (1.62 to 2.55) for prescription drugs, 0.96 (0.83 to 1.13) and 1.14 (0.97 to 1.37) for outpatient services, 1.20 (0.81 to 1.86) and 1.38 (0.91 to 2.14) for inpatient care, and 1.10 (0.91 to 1.35) and 1.36 (1.11 to 1.68) for all medical care.

DISCUSSION

Future healthcare costs are higher for persons who are overweight, especially those with BMIs > or = 30 kg/m(2).

摘要

目的

评估体重指数（BMI）与未来医疗费用之间的关系。

研究方法与步骤

我们在俄勒冈州波特兰市的大型健康维护组织凯撒永久医疗西北分部，对肥胖与未来医疗费用之间的关系进行了一项回顾性队列研究。研究对象（n = 1286）包括那些回复了1990年健康调查问卷的人，该问卷邮寄给了凯撒永久医疗西北分部35至64岁成年会员的随机样本；BMI≥20 kg/m²（基于自我报告的身高和体重）；不吸烟；且无冠心病、中风、人类免疫缺陷病毒或癌症病史。根据1990年的BMI将受试者分层（20至24.9、25至29.9以及≥30 kg/m²；分别为n = 545、474和367）。然后我们统计了他们在9年期间（1990年至1998年）所有住院护理、门诊服务和处方药的费用（以1998年美元计）。

结果

对于BMI为20至24.9 kg/m²的人，在研究期间，处方药、门诊服务、住院护理和所有医疗护理的平均（±标准误）年度费用分别为261美元（±18）、848美元（±59）、532美元（±85）和1631美元（±120）。BMI为25至29.9 kg/m²和≥30 kg/m²的人的费用比率（95%置信区间），处方药分别为1.37（1.12至1.66）和2.05（1.62至2.55），门诊服务为0.96（0.83至1.13）和1.14（0.97至1.37），住院护理为1.20（0.81至1.86）和1.38（0.91至2.14），所有医疗护理为1.10（0.91至1.35）和1.36（1.11至1.68）。