Is Overweight and Class I Obesity Associated with Increased Health Claims Costs?
Is Overweight and Class I Obesity Associated with Increased Health Claims Costs?
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DOI：
10.1002/oby.20669
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发表时间：
2014-04-01
期刊：
影响因子：
6.9
通讯作者：
Dement, John
中科院分区：
文献类型：
--
作者：
Ostbye, Truls;Stroo, Marissa;Dement, John
目标：评估过去十年身体质量指数 (BMI) 与健康索赔费用之间的关系，评估 BMI 与费用之间关系的强度和性质，并识别可能导致费用增加的合并症。方法：使用参加年度健康评估的员工 2001-2011 年的索赔数据，计算年度付费索赔费用。部分负二项式模型适合评估 BMI 与费用之间的关系，控制年龄、性别、种族/族裔和日历年期间。结果：BMI 增加与健康索赔费用增加之间的关系是渐进的，并且从 BMI 为 19 时就开始了。这种关系的性质并没有随着时间的推移而发生显着变化。最重要的肥胖相关合并症（以每 BMI 单位成本增加百分比表示）是心血管疾病（男性 10.53, 95% CI [6.46, 14.77]，女性 4.27, 95% CI [1.25, 7.38]，而心血管药物（7.23, 95% CI [6.08, 8.39]）是药房最重要的驱动因素结论：与最近有关死亡率影响的证据相比，我们观察到健康索赔成本从建议的 BMI 范围的低端开始逐渐增加。
Objectives: Evaluate the relationship between body mass index (BMI) and health claims costs over the last decade, assess the strength and nature of the relationship between BMI and costs, and identify comorbidities that may drive any increased costs.Methods: Using 2001-2011 claims data for employees participating in annual health appraisals, annual paid claims costs were calculated. One-part negative binomial models were fit to evaluate the relationship between BMI and costs, controlling for age, gender, race/ ethnicity, and calendar year period.Results: The relationship between increasing BMI and increasing health claims costs is gradual and starts already at a BMI of 19. The nature of the relationship did not change notably over time. The most important obesity-related comorbidities, expressed as percent increase in cost per BMI unit, was cardiovascular disease (males 10.53, 95% CI [6.46, 14.77], females 4.27, 95% CI [1.25, 7.38), while cardiovascular agents (7.23, 95% CI [6.08, 8.39]) were the most important driver of pharmacy costs.Conclusion: In contrast to recent evidence relating to effects on mortality, we observed a gradual increase in health claims costs starting at the low end of the recommended BMI range.