Kamble Pravin S, Hayden Jennifer, Collins Jenna, Harvey Raymond A, Suehs Brandon, Renda Andrew, Hammer Mette, Huang Joanna, Bouchard Jonathan
a Comprehensive Health Insights Inc. , Louisville , KY , USA.
b Humana Inc , Louisville , KY , USA.
Curr Med Res Opin. 2018 Jul;34(7):1335-1343. doi: 10.1080/03007995.2018.1464435. Epub 2018 May 10.
To examine the association of obesity with healthcare resource utilization (HRU) and costs among commercially insured individuals.
This retrospective observational cohort study used administrative claims from 1 January 2007 to 1 December 2013. The ICD-9-CM status codes (V85 hierarchy) from 2008 to 2012 classified body mass index (BMI) into the World Health Organizations' BMI categories. The date of first observed BMI code was defined as the index date and continuous eligibility for one year pre- and post- index date was ensured. Post-index claims determined individuals' HRU and costs. Sampling weights developed using the entropy balance method and National Health and Nutrition Examination Survey data ensured representation of the US adult commercially insured population. Baseline characteristics were described across BMI classes and associations between BMI categories, and outcomes were examined using multivariable regression.
The cohort included 9651 individuals with BMI V85 codes. After weighting, the BMI distribution was: normal (31.1%), overweight (33.4%), obese class I (22.0%), obese class II (8.1%) and obese class III (5.4%). Increasing BMI was associated with greater prevalence of cardiometabolic conditions, including hypertension, type 2 diabetes and metabolic syndrome. The use of antihypertensives, antihyperlipidemics, antidiabetics, analgesics and antidepressants rose with increasing BMI. Greater BMI level was associated with increased inpatient, emergency department and outpatient utilization, and higher total healthcare, medical and pharmacy costs.
Increasing BMI was associated with higher prevalence of cardiometabolic conditions and higher HRU and costs. There is an urgent need to address the epidemic of obesity and its clinical and economic impacts.
研究商业保险人群中肥胖与医疗资源利用（HRU）及费用之间的关联。
这项回顾性观察队列研究使用了2007年1月1日至2013年12月1日的行政索赔数据。2008年至2012年的ICD - 9 - CM状态码（V85层级）将体重指数（BMI）分类为世界卫生组织的BMI类别。首次观察到BMI代码的日期被定义为索引日期，并确保在索引日期前后各有一年的连续参保资格。索引日期之后的索赔数据确定了个体的医疗资源利用情况和费用。使用熵平衡法和国家健康与营养检查调查数据开发的抽样权重确保了美国成年商业保险人群的代表性。描述了不同BMI类别的基线特征，并使用多变量回归分析了BMI类别与结果之间的关联。
该队列包括9651名有BMI V85代码的个体。加权后，BMI分布为：正常（31.1%）、超重（33.4%）、肥胖I类（22.0%）、肥胖II类（8.1%）和肥胖III类（5.4%）。BMI的增加与心血管代谢疾病的患病率增加相关，包括高血压、2型糖尿病和代谢综合征。随着BMI的增加，抗高血压药、抗高血脂药、抗糖尿病药、镇痛药和抗抑郁药的使用也增加。更高的BMI水平与住院、急诊科和门诊利用率的增加以及更高的总医疗、医疗和药房费用相关。
BMI的增加与心血管代谢疾病的患病率升高以及更高的医疗资源利用和费用相关。迫切需要应对肥胖流行及其临床和经济影响。
