Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany.
Age Ageing. 2015 Jul;44(4):616-23. doi: 10.1093/ageing/afu120. Epub 2015 Mar 31.
excess weight is a risk factor for numerous co-morbidities that predominantly occur in later life. This study's purpose was to analyse the association between excess weight and health service use/costs in the older population in Germany.
this cross-sectional analysis used data of n = 3,108 individuals aged 58-82 from a population-based prospective cohort study. Body mass index (BMI) and waist-to-height ratio (WHtR) were calculated based on clinical examinations. Health service use was measured by a questionnaire for a 3-month period. Corresponding costs were calculated applying a societal perspective.
21.8% of the sample were normal weight, 43.0% overweight, 25.5% obese class 1 and 9.6% obese class ≥2 according to BMI. In 42.6%, WHtR was ≥0.6. For normal weight, overweight, obese class 1 and obese class ≥2 individuals, mean costs (3-month period) of outpatient care were 384€, 435€, 475€ and 525€ (P < 0.001), mean costs of inpatient care were 284€, 408€, 333€ and 652€ (P = 0.070) and mean total costs 716€, 891€, 852€ and 1,244€ (P = 0.013). For individuals with WHtR <0.6 versus ≥0.6, outpatient costs were 401€ versus 499€ (P < 0.001), inpatient costs 315€ versus 480€ (P = 0.016) and total costs 755€ versus 1,041€ (P < 0.001). Multiple regression analyses controlling for sociodemographic variables showed a significant effect of obesity on costs of outpatient care (class 1: +72€; class ≥2: +153€) and total costs (class ≥2: +361€) while the effect of overweight was not significant. WHtR ≥0.6 significantly increased outpatient costs by +79€ and total costs by +189€.
excess weight is associated with increased service use and cost in elderly individuals, in particular in obese class ≥2 individuals.
超重是许多共病的危险因素，这些共病主要发生在晚年。本研究的目的是分析德国老年人群中超重与卫生服务利用/费用之间的关系。
本横断面分析使用了一项基于人群的前瞻性队列研究中 n = 3108 名 58-82 岁个体的数据。根据临床检查计算体重指数（BMI）和腰高比（WHtR）。通过问卷调查测量 3 个月的卫生服务利用情况。应用社会视角计算相应的成本。
根据 BMI，21.8%的样本为正常体重，43.0%为超重，25.5%为 1 级肥胖，9.6%为≥2 级肥胖。在 42.6%的个体中，WHtR≥0.6。对于正常体重、超重、1 级肥胖和≥2 级肥胖的个体，门诊护理的平均费用（3 个月）分别为 384 欧元、435 欧元、475 欧元和 525 欧元（P＜0.001），住院护理的平均费用分别为 284 欧元、408 欧元、333 欧元和 652 欧元（P=0.070），总费用分别为 716 欧元、891 欧元、852 欧元和 1244 欧元（P=0.013）。对于 WHtR＜0.6 和≥0.6 的个体，门诊费用分别为 401 欧元和 499 欧元（P＜0.001），住院费用分别为 315 欧元和 480 欧元（P=0.016），总费用分别为 755 欧元和 1041 欧元（P＜0.001）。在控制社会人口统计学变量的多元回归分析中，肥胖对门诊护理费用（1 级：+72 欧元；≥2 级：+153 欧元）和总费用（≥2 级：+361 欧元）有显著影响，而超重的影响则不显著。WHtR≥0.6 显著增加了门诊费用 79 欧元和总费用 189 欧元。
超重与老年人服务利用和费用增加有关，特别是 2 级以上肥胖者。
