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The Non-Linear Relationship between BMI and Health Care Costs and the Resulting Cost Fraction Attributable to Obesity

1
Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Health Economics and Health Care Management, 85764 Neuherberg, Germany
2
German Center for Diabetes Research, 85764 Neuherberg, Germany
3
Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Epidemiology II, 85764 Neuherberg, Germany
4
Technische Universität München, Klinikum Rechts der Isar, Institute for Nutritional Medicine, 81675 Munich, Germany
*
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2017, 14(9), 984; https://doi.org/10.3390/ijerph14090984
Received: 3 July 2017 / Revised: 23 August 2017 / Accepted: 24 August 2017 / Published: 30 August 2017
(This article belongs to the Section Health Economics)
This study aims to analyse the non-linear relationship between Body Mass Index (BMI) and direct health care costs, and to quantify the resulting cost fraction attributable to obesity in Germany. Five cross-sectional surveys of cohort studies in southern Germany were pooled, resulting in data of 6757 individuals (31–96 years old). Self-reported information on health care utilisation was used to estimate direct health care costs for the year 2011. The relationship between measured BMI and annual costs was analysed using generalised additive models, and the cost fraction attributable to obesity was calculated. We found a non-linear association of BMI and health care costs with a continuously increasing slope for increasing BMI without any clear threshold. Under the consideration of the non-linear BMI-cost relationship, a shift in the BMI distribution so that the BMI of each individual is lowered by one point is associated with a 2.1% reduction of mean direct costs in the population. If obesity was eliminated, and the BMI of all obese individuals were lowered to 29.9 kg/m2, this would reduce the mean direct costs by 4.0% in the population. Results show a non-linear relationship between BMI and health care costs, with very high costs for a few individuals with high BMI. This indicates that population-based interventions in combination with selective measures for very obese individuals might be the preferred strategy. View Full-Text
Keywords: obesity; overweight; health care costs; attributable fraction; Germany obesity; overweight; health care costs; attributable fraction; Germany
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MDPI and ACS Style

Laxy, M.; Stark, R.; Peters, A.; Hauner, H.; Holle, R.; Teuner, C.M. The Non-Linear Relationship between BMI and Health Care Costs and the Resulting Cost Fraction Attributable to Obesity. Int. J. Environ. Res. Public Health 2017, 14, 984. https://doi.org/10.3390/ijerph14090984

AMA Style

Laxy M, Stark R, Peters A, Hauner H, Holle R, Teuner CM. The Non-Linear Relationship between BMI and Health Care Costs and the Resulting Cost Fraction Attributable to Obesity. International Journal of Environmental Research and Public Health. 2017; 14(9):984. https://doi.org/10.3390/ijerph14090984

Chicago/Turabian Style

Laxy, Michael; Stark, Renée; Peters, Annette; Hauner, Hans; Holle, Rolf; Teuner, Christina M. 2017. "The Non-Linear Relationship between BMI and Health Care Costs and the Resulting Cost Fraction Attributable to Obesity" Int. J. Environ. Res. Public Health 14, no. 9: 984. https://doi.org/10.3390/ijerph14090984

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