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Journal of Public Health

, 15:377 | Cite as

Healthcare utilization of overweight and obese Europeans aged 50–79 years

  • I. Peytremann-BridevauxEmail author
  • B. Santos-Eggimann
Original Article

Abstract

To examine the association between overweight/obesity and healthcare utilization in middle-aged and aged Europeans. This is a baseline cross-sectional analysis of self-reported data from ten countries participating in the Survey of Health, Ageing and Retirement in Europe (SHARE), which reached an overall response rate of 62%. Included in the study were 16,695 non-institutionalized individuals aged 50–79 years with body mass indexes (BMI) ≥18.5 kg/m2. We used height and weight to compute BMI and categorized it into normal weight (BMI 18.5–24.9 kg/m2), overweight (BMI 25.0–29.9 kg/m2) and obesity (BMI ≥ 30 kg/m2). Dichotomous measures of healthcare utilization during the previous 12 months included any use of ambulatory care, high use of a general practitioner, visits to specialists, high use of medication, hospitalization, high number of times hospitalized and nights spent in the hospital, surgery, home healthcare and domestic help. Logistic regressions adjusted for age, socio-economic status, smoking, physical activity, alcohol consumption, country of residence, and chronic conditions. All analyses were stratified by gender. Among men and women, being overweight or obese was associated with a significantly increased risk of using ambulatory care and visiting general practitioners, as well as taking ≥2 medication categories. Those relationships were only partially explained by chronic conditions. Obese women were at increased risk and overweight men at decreased risk of hospitalization. For men, exploring other hospitalization dimensions did not reveal significant associations, however. Men and women, whether overweight or obese, did not report higher use of specialists, surgery, home healthcare or domestic help. For all outcomes, similar trends were found at the country level. Population-attributable fractions were highest for medication use, both for men (23%) and women (19%). Despite the rising prevalence of obesity and aging of the population, findings from SHARE show that overweight and obesity place a moderate burden on European healthcare systems, mostly by increasing ambulatory care and medication use.

Keywords

Obesity Overweight Healthcare utilization Population-based study 

Notes

Acknowledgments

This paper uses data from the early release 1 of SHARE 2004. This release may contain errors that will be corrected in later releases. The SHARE data collection has been primarily funded by the European Commission through the 5th framework program (project QLK6-CT-2001-00360 in the thematic program Quality of Life). Additional funding came from the US National Institute on Aging (U01 AG09740-13S2, P01 AG005842, P01 AG08291, P30 AG12815, Y1-AG-4553-01 and OGHA 04-064). Data collection in Austria (through the Austrian Science Fund, FWF), Belgium (through the Belgian Science Policy Office) and Switzerland (through BBW/OFES/UFES) was nationally funded. The SHARE data set was introduced in Börsch-Supan et al. (2005); methodological details are contained in Börsch-Supan and Jürges (2005).

Conflict of interest statement

Both authors affirm that there is no actual or potential conflict of interest in relation to this article and no financial interest/arrangement with one or more organizations that could be perceived as a real or apparent conflict of interest in the context of the subject of this article.

References

  1. Andreyeva T, Sturm R, Ringel JS (2004) Moderate and severe obesity have large differences in health care costs. Obes Res 12:1936–1943PubMedGoogle Scholar
  2. Arterburn DE, McDonell MB, Hedrick SC, Diehr P, Fihn SD (2004) Association of body weight with condition-specific quality of life in male veterans. Am J Med 117:738–746PubMedCrossRefGoogle Scholar
  3. Bertakis KD, Azari R (2005) Obesity and the use of health care services. Obes Res 13:372–379PubMedGoogle Scholar
  4. Börsch-Supan A, Jürges H (2005) The survey of health, ageing and retirement in Europe: methodology. Mannheim Research Institute for the Economics of Aging (MEA), MannheimGoogle Scholar
  5. Börsch-Supan A, Hank K, Jürges H (2005) A new comprehensive and international view on ageing: introducing the "Survey of Health, Ageing and Retirement in Europe". Eur J Ageing 2:245–253CrossRefGoogle Scholar
  6. Colombo F, Tapay N (2004) Private health insurance in OECD countries: the benefits and costs for individuals and health systems. OECD Publishing, ParisGoogle Scholar
  7. Connor Gorber S, Tremblay M, Moher D, Gorber B (2007) A comparison of direct vs. self-reported measures for assessing height, weight and body mass index: a systematic review. Obes Rev. Published article online 26-Jan-2007, DOI:  10.1111/j.1467-789X.2007.00347.x
  8. Field AE, Coakley EH, Must A, Spadano JL, Laird N, Dietz WH et al (2001) Impact of overweight on the risk of developing common chronic diseases during a 10-year period. Arch Intern Med 161:1581–1586PubMedCrossRefGoogle Scholar
  9. Flegal KM, Carroll MD, Ogden CL, Johnson CL (2002) Prevalence and trends in obesity among US adults, 1999–2000. JAMA 288:1723–1727PubMedCrossRefGoogle Scholar
  10. Fontaine KR, Barofsky I (2001) Obesity and health-related quality of life. Obes Rev 2:173–182PubMedCrossRefGoogle Scholar
  11. Fontaine KR, Faith MS, Allison DB, Cheskin LJ (1998) Body weight and health care among women in the general population. Arch Fam Med 7:381–384PubMedCrossRefGoogle Scholar
  12. Groessl EJ, Kaplan RM, Barrett-Connor E, Ganiats TG (2004) Body mass index and quality of well-being in a community of older adults. Am J Prev Med 26:126–129PubMedCrossRefGoogle Scholar
  13. Guallar-Castillon P, Lopez GE, Lozano PL, Gutierrez-Fisac JL, Banegas Banegas JR, Lafuente Urdinguio PJ et al (2002) The relationship of overweight and obesity with subjective health and use of health-care services among Spanish women. Int J Obes Relat Metab Disord 26:247–252PubMedCrossRefGoogle Scholar
  14. Haslam DW, James WP (2005) Obesity. Lancet 366:1197–1209PubMedCrossRefGoogle Scholar
  15. Larrieu S, Peres K, Letenneur L, Berr C, Dartigues JF, Ritchie K et al (2004) Relationship between body mass index and different domains of disability in older persons: the 3C study. Int J Obes Relat Metab Disord 28:1555–1560PubMedCrossRefGoogle Scholar
  16. Lean ME, Han TS, Seidell JC (1999) Impairment of health and quality of life using new US federal guidelines for the identification of obesity. Arch Intern Med 159:837–843PubMedCrossRefGoogle Scholar
  17. Leon-Munoz LM, Guallar-Castillon P, Lopez Garcia E, Banegas JR, Gutierrez-Fisac JL, Rodriguez-Artalejo F (2005) Relationship of BMI, waist circumference, and weight change with use of health services by older adults. Obes Res 13:1398–1404PubMedGoogle Scholar
  18. Lloyd-Sherlock P (2000) Population ageing in developed and developing regions: implications for health policy. Soc Sci Med 51:887–895PubMedCrossRefGoogle Scholar
  19. Luchsinger JA, Lee WN, Carrasquillo O, Rabinowitz D, Shea S (2003) Body mass index and hospitalization in the elderly. J Am Geriatr Soc 51:1615–1620PubMedCrossRefGoogle Scholar
  20. Meisinger C, Heier M, Loewel H (2004) The relationship between body weight and health care among German women. Obes Res 12:1473–1480PubMedGoogle Scholar
  21. Mokdad AH, Bowman BA, Ford ES, Vinicor F, Marks JS, Koplan JP (2001) The continuing epidemics of obesity and diabetes in the United States. JAMA 286:1195–1200PubMedCrossRefGoogle Scholar
  22. Ostbye T, Taylor DH, Jung SH (2002) A longitudinal study of the effects of tobacco, smoking and other modifiable risk factors on ill health in middle-aged and old Americans: results fomr the Health and Retirement Study and Asset and Health Dynamics among the Oldest Old Survey. Prev Med 34:334–345PubMedCrossRefGoogle Scholar
  23. Palta M, Prineas RJ, Berman R, Hannan P (1982) Comparison of self-reported and measured height and weight. Am J Epidemiol 115:223–230PubMedGoogle Scholar
  24. Patterson RE, Frank LL, Kristal AR, White E (2004) A comprehensive examination of health conditions associated with obesity in older adults. Am J Prev Med 27:385–390PubMedCrossRefGoogle Scholar
  25. Quesenberry CP Jr, Caan B, Jacobson A (1999) Obesity, health services use, and health care costs among members of a health maintenance organization. Arch Intern Med 158:466–472CrossRefGoogle Scholar
  26. Raebel MA, Malone DC, Conner DA, Xu S, Porter JA, Lanty FA (2004) Health services use and health care costs of obese and non obese individuals. Arch Intern Med 164:2135–2140PubMedCrossRefGoogle Scholar
  27. Reidpath DD, Crawford D, Tilgner L, Gibbons C (2002) Relationship between body mass index and the use of healthcare services in Australia. Obes Res 10:526–531PubMedCrossRefGoogle Scholar
  28. Rockhill B, Newman B, Weinberg C (1998) Use and misuse of population attributable fractions. Am J Public Health 88:15–19PubMedCrossRefGoogle Scholar
  29. Sturm R, Ringel JS, Andreyeva T (2004) Increasing obesity rates and disability trends. Health Aff (Millwood) 23:199–205CrossRefGoogle Scholar
  30. Trakas K, Lawrence K, Shear NH (1999) Utilization of health care resources by obese Canadians. CMAJ 160:1457–1462PubMedGoogle Scholar
  31. von Lengerke T, Happich M, Reitmeir P, John J for the KORA Study Group (2005) Utilization of out- and inpatient health services by obese adults: a population-based study in the Augsburg region, Germany. Gesundheitswesen 67(Suppl 1):S150–S157CrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  1. 1.Health Services Research Unit, Institute of Social and Preventive MedicineUniversity of LausanneLausanneSwitzerland
  2. 2.Institute of Health Economics and ManagementUniversity of LausanneLausanneSwitzerland

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