Christina Hansen Edwards, Johan Håkon Bjørngaard, Jonas Minet Kinge, Gunnhild Åberge Vie, Vidar Halsteinli, Rønnaug Ødegård, Bård Kulseng, Gudrun Waaler Bjørnelv
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The healthcare costs of increased body mass index-evidence from The Trøndelag Health Study.
Background: Earlier studies have estimated the impact of increased body mass index (BMI) on healthcare costs. Various methods have been used to avoid potential biases and inconsistencies. Each of these methods measure different local effects and have different strengths and weaknesses.
Methods: In the current study we estimate the impact of increased BMI on healthcare costs using nine common methods from the literature: multivariable regression analyses (ordinary least squares, generalized linear models, and two-part models), and instrumental variable models (using previously measured BMI, offspring BMI, and three different weighted genetic risk scores as instruments for BMI). We stratified by sex, investigated the implications of confounder adjustment, and modelled both linear and non-linear associations.
Results: There was a positive effect of increased BMI in both males and females in each approach. The cost of elevated BMI was higher in models that, to a greater extent, account for endogenous relations.
Conclusion: The study provides solid evidence that there is an association between BMI and healthcare costs, and demonstrates the importance of triangulation.
期刊介绍:
Health Economics Review is an international high-quality journal covering all fields of Health Economics. A broad range of theoretical contributions, empirical studies and analyses of health policy with a health economic focus will be considered for publication. Its scope includes macro- and microeconomics of health care financing, health insurance and reimbursement as well as health economic evaluation, health services research and health policy analysis. Further research topics are the individual and institutional aspects of health care management and the growing importance of health care in developing countries.