Health Analytics, Lane Clark & Peacock LLP, London, UK.
Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, UK.
Diabetes Obes Metab. 2024 Nov;26(11):5036-5045. doi: 10.1111/dom.15785. Epub 2024 Aug 19.
To estimate healthcare resource utilization (HCRU) and healthcare costs by body mass index (BMI) in a UK cohort and to explore how this varied by defined BMI strata.
This retrospective open cohort study used Discover, a linked primary and secondary electronic health records database covering 2.7 million individuals. Adults were stratified by BMI as: overweight (25-<30 kg/m); obesity class I (30-<35 kg/m); obesity class II (35-<40 kg/m); or obesity class III (≥40 kg/m). Cost data, comprising primary care, secondary care (inpatient admissions, outpatient appointments and emergency room visits) and prescriptions, were reported for 2015-2019.
Overall, 1 008 101 individuals were overweight, 278 782 had obesity class I; 80 621 had obesity class II, and 42 642 had obesity class III. Healthcare costs and HCRU events per person per year increased over time (2015: £851-£1321 and 10.6-13.4 events; 2019: £1143-£1871 and 11.4-14.9 events), and were higher for each successive BMI group. Groups with chronic kidney disease or cardiovascular disease incurred particularly high costs. In 270 493 individuals with obesity in 2019, more than 72% of total healthcare costs were incurred by the highest cost quintile, which had a higher mean age and more obesity-related complications (ORCs) than lower cost quintiles.
The economic impact of obesity could be alleviated by weight management support based on unmet need, to limit the effects of BMI progression and ORC development.
评估英国队列中体重指数（BMI）相关的医疗资源利用（HCRU）和医疗成本，并探讨其在不同 BMI 分层中的差异。
本回顾性开放性队列研究使用了 Discover，这是一个链接的初级和二级电子健康记录数据库，涵盖了 270 万人。成年人按 BMI 分层：超重（25-<30kg/m）；肥胖 I 级（30-<35kg/m）；肥胖 II 级（35-<40kg/m）；肥胖 III 级（≥40kg/m）。2015-2019 年报告了成本数据，包括初级保健、二级保健（住院、门诊预约和急诊就诊）和处方。
总体而言，1008101 人超重，278782 人肥胖 I 级；80621 人肥胖 II 级，42642 人肥胖 III 级。医疗保健成本和每人每年的 HCRU 事件随时间推移而增加（2015 年：851-1321 英镑和 10.6-13.4 次；2019 年：1143-1871 英镑和 11.4-14.9 次），且每个连续的 BMI 组都更高。患有慢性肾脏疾病或心血管疾病的人群成本特别高。在 2019 年患有肥胖症的 270493 人中，超过 72%的总医疗保健成本由最高成本五分位数承担，该五分位数的平均年龄更高，并且比较低成本五分位数具有更多的肥胖相关并发症（ORC）。
通过基于未满足需求的体重管理支持，可以减轻肥胖症的经济影响，以限制 BMI 进展和 ORC 发展的影响。
