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Quantifying the causal impact of biological risk factors on healthcare costs

Author

Listed:
  • Jiwoo Lee

    (Broad Institute of MIT and Harvard
    University of Helsinki
    Broad Institute of Harvard and MIT
    Massachusetts General Hospital)

  • Sakari Jukarainen

    (University of Helsinki)

  • Antti Karvanen

    (University of Helsinki)

  • Padraig Dixon

    (University of Oxford)

  • Neil M. Davies

    (University College London
    University College London
    Norwegian University of Science and Technology
    University of Bristol)

  • George Davey Smith

    (University of Bristol)

  • Pradeep Natarajan

    (Broad Institute of MIT and Harvard
    Broad Institute of Harvard and MIT
    Massachusetts General Hospital
    Harvard Medical School)

  • Andrea Ganna

    (Broad Institute of MIT and Harvard
    University of Helsinki
    Massachusetts General Hospital)

Abstract

Understanding the causal impact that clinical risk factors have on healthcare-related costs is critical to evaluate healthcare interventions. Here, we used a genetically-informed design, Mendelian Randomization (MR), to infer the causal impact of 15 risk factors on annual total healthcare costs. We calculated healthcare costs for 373,160 participants from the FinnGen Study and replicated our results in 323,774 individuals from the United Kingdom and Netherlands. Robust causal effects were observed for waist circumference (WC), adult body mass index, and systolic blood pressure, in which a standard deviation increase corresponded to 22.78% [95% CI: 18.75-26.95], 13.64% [10.26-17.12], and 13.08% [8.84-17.48] increased healthcare costs, respectively. A lack of causal effects was observed for certain clinically relevant biomarkers, such as albumin, C-reactive protein, and vitamin D. Our results indicated that increased WC is a major contributor to annual total healthcare costs and more attention may be given to WC screening, surveillance, and mitigation.

Suggested Citation

  • Jiwoo Lee & Sakari Jukarainen & Antti Karvanen & Padraig Dixon & Neil M. Davies & George Davey Smith & Pradeep Natarajan & Andrea Ganna, 2023. "Quantifying the causal impact of biological risk factors on healthcare costs," Nature Communications, Nature, vol. 14(1), pages 1-11, December.
    • Handle: RePEc:nat:natcom:v:14:y:2023:i:1:d:10.1038_s41467-023-41394-4
    DOI: 10.1038/s41467-023-41394-4
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    References listed on IDEAS

    as
    1. Padraig Dixon & George Davey Smith & William Hollingworth, 2019. "The Association Between Adiposity and Inpatient Hospital Costs in the UK Biobank Cohort," Applied Health Economics and Health Policy, Springer, vol. 17(3), pages 359-370, June.
    2. Tian Ge & Chia-Yen Chen & Yang Ni & Yen-Chen Anne Feng & Jordan W. Smoller, 2019. "Polygenic prediction via Bayesian regression and continuous shrinkage priors," Nature Communications, Nature, vol. 10(1), pages 1-10, December.
    3. Dixon, Padraig & Hollingworth, William & Harrison, Sean & Davies, Neil M. & Davey Smith, George, 2020. "Mendelian Randomization analysis of the causal effect of adiposity on hospital costs," Journal of Health Economics, Elsevier, vol. 70(C).
    4. Sean Harrison & Padraig Dixon & Hayley E Jones & Alisha R Davies & Laura D Howe & Neil M Davies, 2021. "Long-term cost-effectiveness of interventions for obesity: A mendelian randomisation study," PLOS Medicine, Public Library of Science, vol. 18(8), pages 1-24, August.
    5. Mitja I. Kurki & Juha Karjalainen & Priit Palta & Timo P. Sipilä & Kati Kristiansson & Kati M. Donner & Mary P. Reeve & Hannele Laivuori & Mervi Aavikko & Mari A. Kaunisto & Anu Loukola & Elisa Lahtel, 2023. "Author Correction: FinnGen provides genetic insights from a well-phenotyped isolated population," Nature, Nature, vol. 615(7952), pages 19-19, March.
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    7. Hazewinkel, Audinga-Dea & Richmond, Rebecca C. & Wade, Kaitlin H. & Dixon, Padraig, 2022. "Mendelian randomization analysis of the causal impact of body mass index and waist-hip ratio on rates of hospital admission," Economics & Human Biology, Elsevier, vol. 44(C).
    8. Dixon, Padraig & Harrison, Sean & Hollingworth, William & Davies, Neil M. & Davey Smith, George, 2022. "Estimating the causal effect of liability to disease on healthcare costs using Mendelian Randomization," Economics & Human Biology, Elsevier, vol. 46(C).
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