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Session: Impact of Obesity
Room: Ball Room
Time: Thu 10:15-11:30

Presenter: Silke Wolfenstetter (Helmholtz Zentrum München – German Research Center for Environmental Health . Institute of Health Economics and Health Care Management)

Abstract

Introduction: Over the past several decades there has been a dramatical increase in the prevalence of obesity worldwide and in Germany. Overweight is one of the leading risk factors, responsible for different morbidities like hypertension, cardiovascular disease and type 2 diabetes, all associated with high costs for the health care system.
Objective: The present analysis aims to analyze the correlation between the Body Mass Index (BMI) and the future direct and indirect costs.
Method: In a sample of 2581 participants of the KORA Survey S3 (1994/95) and the Follow-up Survey F3 (2004/05), a cross-sectional health survey of the adult population (age 25-65 years) in Augsburg region, Germany was conducted. Health care utilization (inpatient and outpatient utilization), productivity loss as well as antropometically measured BMI (kg/m²) were assessed. According to the World Health Organization (WHO) definitions, the following BMI- stratification was used for the analysis: healthy weight: 18.5≤BMI<25; preobesity: 25≤BMI<30; moderate obesity: 30≤BMI<35; severe obesity: BMI≥35. Health care utilization was valued as recommended by the working Group “Methods in Health Economic Evaluation” and productivity loss by the data of the Federal Statistical Office of Germany and adjusted to the year of 2005. A generalised linear regression model with gamma distribution and loglink-function was calculated to model the relationship between BMI (1994/95) and the future health care costs 10 years later. In order to assess the relationship between BMI (1994/95) and health care costs including potential explanatory covariables as age, gender and socioeconomic status (Helmert Index), a multiple generalised linear model with gamma distribution and log transformation was calculated. In each of the models the four BMI classes defined the focal regressor, using “healthy weight” as reference group.
Results: The predicted average adjusted total direct medical costs per year and participant were estimated to be €863 (healthy weight), €959 (preobesity), €934 (moderate obesity), and €885 (severe obesity). There is a significant increase of future costs in utilization of general practitioners per person and year depending on the obesity class: €47 (healthy weight), €54 (preobesity; p<0.05), €61 (moderate obesity; p<0.05), and €85 (severe obesity; p<0.01). The average future indirect costs increase significantly in the first three BMI classes: €1145 (healthy weight), €1646 (preobesity; p<0.01), €2072 (moderate obesity; p<0.001), and €1273 (severe obesity).
Conclusion: There is a trend for increasing future (in)-direct costs. This can be mainly recognized in the first three BMI- categories (healthy weight, preobesity, moderate obesity).
Potential future cost savings could be attained if preventive programs effectively targeted overweight or moderate obese individuals.

Kora Study-Group consists of H.E. Wichmann (speaker), A. Peters, C. Meisinger, A. Döring, T. Illig, R. Holle, J. John and coworkers who are responsible for the design and conduct of KORA studies.

Key Terms

body mass index, case-cohort study, future health care costs, obesity

Authors:

Silke B. Wolfenstetter (Helmholtz Zentrum München – German Research Center for Environmental Health . Institute of Health Economics and Health Care Management)

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