Skip to content

The Association Between Adiposity and Inpatient Hospital Costs in the UK Biobank Cohort

Research output: Contribution to journalArticle

Original languageEnglish
Pages (from-to)359-370
Number of pages12
JournalApplied Health Economics and Health Policy
Volume17
Issue number3
Early online date30 Dec 2018
DOIs
DateSubmitted - 24 Aug 2018
DateAccepted/In press - 9 Nov 2018
DateE-pub ahead of print - 30 Dec 2018
DatePublished (current) - 1 Jun 2019

Abstract

Background
High adiposity is associated with higher risks for a variety of adverse health outcomes, including higher rates of age-adjusted mortality and increased morbidity. This has important implications for the management of healthcare systems, since the endocrinal, cardiometabolic and other changes associated with increased adiposity may be associated with substantial healthcare costs.

Methods
We studied the association between various measures of adiposity and inpatient hospital costs through record linkage between UK Biobank and records of inpatient care in England and Wales. UK Biobank is a large prospective cohort study that aimed to recruit men and women aged between 40 and 69 from 2006 to 2010. We applied generalised linear models to cost per person year to estimate the marginal effect and averaged adjusted predicted cost of adiposity on inpatient costs.

Results
Valid cost and body mass index (BMI) data from 457,689 participants were available for inferential analysis. Some 54.4% of individuals included in the analysis sample had positive inpatient healthcare costs over the period of follow-up. Median hospital costs per person year of follow-up were £89, compared to mean costs of £481. Mean BMI overall was 27.4 kg/m2 (standard deviation 4.8). The marginal effect of a unit increase in BMI was £13.61 (99% confidence interval: £12.60 to £14.63) per person year of follow up. The marginal effect of a standard deviation increase in BMI was £69.20 (99% confidence interval: £64.98 to £73.42). The marginal effect of becoming obese was £136.35 (99% confidence interval: £124.62 to £148.08). Average adjusted predicted inpatient hospital costs increased almost linearly when modelled using continuous measure of adiposity. Sensitivity analysis of different scenarios did not substantially change these conclusions, although there was some evidence of attenuation of the effects of adiposity when controlling for waist-hip ratios, and when individuals who self-reported any pre-existing conditions were excluded from analysis.

Conclusions
Higher adiposity is associated with higher inpatient hospital costs. Further scrutiny using causal inferential methods is warranted to establish if further public health investments are required to manage the large healthcare costs observationally associated with overweight and obesity.

Download statistics

No data available

Documents

Documents

  • Full-text PDF (final published version)

    Rights statement: This is the final published version of the article (version of record). It first appeared online via Springer at https://link.springer.com/article/10.1007%2Fs40258-018-0450-2 . Please refer to any applicable terms of use of the publisher.

    Final published version, 1 MB, PDF-document

    Licence: CC BY

DOI

View research connections

Related faculties, schools or groups