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The Relationship between Body Mass Index and Hospitalisation Rates, Days in Hospital and Costs: Findings from a Large Prospective Linked Data Study

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  • Rosemary J Korda
  • Grace Joshy
  • Ellie Paige
  • James R G Butler
  • Louisa R Jorm
  • Bette Liu
  • Adrian E Bauman
  • Emily Banks

Abstract

Background: Internationally there is limited empirical evidence on the impact of overweight and obesity on health service use and costs. We estimate the burden of hospitalisation—admissions, days and costs—associated with above-normal BMI. Methods: Population-based prospective cohort study involving 224,254 adults aged ≥45y in Australia (45 and Up Study). Baseline questionnaire data (2006-2009) were linked to hospitalisation and death records (median follow-up 3.42y) and hospital cost data. The relationships between BMI and hospital admissions and days were modelled using zero-inflated negative binomial regression; generalised gamma models were used to model costs. Analyses were stratified by sex and age (45-64, 65-79, ≥80y), and adjusted for age, area of residence, education, income, smoking, alcohol-intake and private health insurance status. Population attributable fractions were also calculated. Results: There were 459,346 admissions (0.55/person-year) and 1,483,523 hospital days (1.76/person-year) during follow-up. For ages 45-64y and 65-79y, rates of admissions, days and costs increased progressively with increments of above-normal BMI. Compared to BMI 22.5-

Suggested Citation

  • Rosemary J Korda & Grace Joshy & Ellie Paige & James R G Butler & Louisa R Jorm & Bette Liu & Adrian E Bauman & Emily Banks, 2015. "The Relationship between Body Mass Index and Hospitalisation Rates, Days in Hospital and Costs: Findings from a Large Prospective Linked Data Study," PLOS ONE, Public Library of Science, vol. 10(3), pages 1-16, March.
    • Handle: RePEc:plo:pone00:0118599
    DOI: 10.1371/journal.pone.0118599
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    References listed on IDEAS

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    1. Knai, Cecile & Suhrcke, Marc & Lobstein, Tim, 2007. "Obesity in Eastern Europe: An overview of its health and economic implications," Economics & Human Biology, Elsevier, vol. 5(3), pages 392-408, December.
    2. Allison, D.B. & Zannolli, R. & Narayan, K.M.V., 1999. "The direct health care costs of obesity in the United States," American Journal of Public Health, American Public Health Association, vol. 89(8), pages 1194-1199.
    3. Glick, Henry A & Doshi, Jalpa A & Sonnad, Seema S & Polsky, Daniel, 2007. "Economic Evaluation in Clinical Trials," OUP Catalogue, Oxford University Press, number 9780198529972.
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    1. Ana P. Johnson & Joel L. Parlow & Brian Milne & Marlo Whitehead & Jianfeng Xu & Susan Rohland & Joelle B. Thorpe, 2017. "Economies of scale: body mass index and costs of cardiac surgery in Ontario, Canada," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 18(4), pages 471-479, May.
    2. 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).
    3. Darren J. Mayne & Geoffrey G. Morgan & Bin B. Jalaludin & Adrian E. Bauman, 2019. "Area-Level Walkability and the Geographic Distribution of High Body Mass in Sydney, Australia: A Spatial Analysis Using the 45 and Up Study," IJERPH, MDPI, vol. 16(4), pages 1-29, February.

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