Changing BMI categories and healthcare expenditures among elderly Medicare beneficiaries.
Changing BMI categories and healthcare expenditures among elderly Medicare beneficiaries.
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改变老年医疗保险受益人的 BMI 类别和医疗保健支出。
DOI：
10.1038/oby.2011.86
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发表时间：
2012
期刊：
影响因子：
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通讯作者：
Sambamoorthi,Usha
中科院分区：
文献类型：
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作者：
Wilkins,TriciaLee;Rust,GeorgeS;Sambamoorthi,Usha
利用2000-2005年医疗保险现行受益人调查(MCBS)的纵向数据，检验老年医疗保险受益人的体重指数类别变化与医疗支出之间的关系。BMI的变化是：(I)保持正常：基线和随访时BMI正常的个人；(Ii)基线和随访时BMI超标的超重个体；(Iii)基线和随访时BMI肥胖的肥胖个体；(Iv)正常-超重：基线BMI正常、后续BMI超重的个体；(V)超重肥胖：基线BMI超重、随访时BMI肥胖的个体；(Vi)超重-正常：基线BMI超重、随访时BMI正常的个体；(Vii)肥胖-超重：基线时体重指数肥胖，随访时体重指数超重的个人。使用记录的第3年支出的普通最小二乘(OLS)模型来分析BMI类别之间支出的变化。总体而言，35%的人保持正常，34%的人保持超重，18%的人保持肥胖，4%的人因正常超重的BMI而增加体重，3%的人因超重的BMI增加体重，5%的人因超重-正常的BMI而减重，3%的人因肥胖-超重的BMI而减重。调整后的模型显示，持续肥胖的人的总支出和多种支出类型显著高于保持正常的人，包括总支出(11%)、门诊支出(25%)、处方支出(9%)和医疗提供者支出(4%)。与保持正常相比，肥胖-超重和超重-肥胖的总支出都高出26%。目前的研究结果强调了在老年人中保持正常BMI的重要性。
To examine the association between changes in BMI categories and health‐care expenditures among elderly Medicare beneficiaries using longitudinal data of the Medicare Current Beneficiary Survey (MCBS) 2000–2005. Changes in BMI were (i) Stayed Normal: individuals with a normal BMI at baseline and follow‐up; (ii) Stayed Overweight individuals with overweight BMI at baseline and follow‐up; (iii) Stayed Obese individuals with obese BMI at baseline and follow‐up; (iv) Normal‐Overweight: individuals with normal BMI at baseline and overweight BMI at follow‐up; (v) Overweight‐Obese: individuals with overweight BMI at baseline and obese BMI at follow‐up; (vi) Overweight‐Normal: individuals with overweight BMI at baseline and normal BMI at follow‐up; (vii) Obese‐Overweight: individuals with obese BMI at baseline and overweight BMI at follow‐up. Ordinary Least Squares (OLS) models on logged Year 3 expenditures were used to analyze changes in expenditures between BMI categories. Overall, 35% Stayed Normal, 34% Stayed Overweight, 18% Stayed Obese, 4% gained weight from Normal‐Overweight BMI, 3% gained weight from Overweight‐Obese BMI, 5% lost weight from Overweight‐Normal BMI, and 3% lost weight from Obese‐Overweight BMI. Adjusted models revealed those who Stayed Obese had increased total and multiple expenditure types that were significantly higher than Stayed Normal including total (11%), outpatient (25%), prescription (9%), and medical provider (4%). Compared to Stayed Normal, total expenditures were both 26% higher for Obese‐Overweight and Overweight‐Obese. The current findings highlight the importance of maintaining a normal BMI in the elderly.