Musich Shirley, MacLeod Stephanie, Bhattarai Gandhi R, Wang Shaohung S, Hawkins Kevin, Bottone Frank G, Yeh Charlotte S
Advanced Analytics, Optum, Ann Arbor, MI, USA.
Scriptorium Medical Writing, Inc., Morrisville, NC, USA.
Gerontol Geriatr Med. 2016 Jan 19;2:2333721415622004. doi: 10.1177/2333721415622004. eCollection 2016 Jan-Dec.
Obesity is a contributor to increased chronic conditions resulting in higher utilization of medical services among broad populations of older adults. The objective of this study was to evaluate the magnitude of the impact of weight on health care use patterns among Medicare Supplement insureds. We estimated the impact of weight as a function of body mass index (BMI) on health care utilization and expenditures using propensity weighted multivariate regression models. The outcomes were controlled initially for demographics and socioeconomics and then additionally for chronic conditions and health status. Among the 9,484 survey respondents, 22.9% were obese. Those categorized as obese were significantly more likely to incur inpatient admissions and orthopedic procedures. Annualized health care expenditures were US$1,496 higher for obese compared with normal weight. The excess utilization and expenditures associated with obesity were explained by chronic conditions and poor health status. Obesity-related expenditures associated with medical management are largely preventable and may benefit from interventions that target lifestyle behaviors and weight management among older adults.
肥胖是导致慢性病增加的一个因素，这使得广大老年人群体对医疗服务的利用率更高。本研究的目的是评估体重对参加了医疗保险补充计划的人群的医疗保健使用模式的影响程度。我们使用倾向加权多元回归模型，估计体重作为身体质量指数（BMI）的函数对医疗保健利用率和支出的影响。结果最初控制了人口统计学和社会经济因素，然后又控制了慢性病和健康状况。在9484名调查受访者中，22.9%为肥胖者。被归类为肥胖的人更有可能住院和接受骨科手术。肥胖者的年化医疗保健支出比正常体重者高出1496美元。与肥胖相关的额外利用率和支出可以通过慢性病和健康状况不佳来解释。与医疗管理相关的肥胖相关支出在很大程度上是可以预防的，针对老年人生活方式行为和体重管理的干预措施可能会从中受益。
