title: Expenditure on health care in obese women with and without sleep apnea.
abstract: OBJECTIVE
  To determine the effect of obesity and sleep apnea on health care expenditure in women over 10 years.
  
  
  METHODS
  Retrospective observational study
  
  
  METHODS
  Tertiary university-based medical center
  
  
  METHODS
  Three groups of age-matched women: 223 obese women with OSAS (body mass index: 39.3 +/- 0.6 kg/m2), and from the general population, 223 obese controls (BMI 36.3 +/- 0.4) and 223 normal weight controls (BMI 23.9 +/- 0.4).
  
  
  METHODS
  None.
  
  
  RESULTS
  We examined health care utilization in the 3 matched groups for the 10 years leading up to the documentation of OSAS. The mean physician fees and the number of physician visits were significantly higher in obese controls than in normal weight controls during the observed period. Physician fees and physician visits progressively increased in the 10 years before diagnosis in the OSAS cases and were significantly higher than in the matched obese controls. Physician fees, in Canadian dollars, one year before diagnosis in the OSAS cases were higher than in obese controls: $547.49 +/- 34.79 vs $246.85 +/- 20.88 (P<0.0001). More was spent for OSAS cases on physician fees for circulatory, endocrine and metabolic diseases, and mental disorders than the obese controls. Physician visits one year before diagnosis in the OSAS cases were more frequent than in the obese controls: 13.2 +/- 0.73 visits vs 7.26 +/- 0.49 visits (P<0.0001).
  
  
  CONCLUSIONS
  Obese women are heavier users of health services than normal weight controls. Obese women with OSAS use significantly more health services than obese controls. Since OSAS imposes a greater financial burden, treatment of OSAS may reduce other comorbidities and lower overall medical costs.
authors.affiliation: Sleep Disorders Centre, Kitatsushima Hospital, Inazawa-city, Aichi, Japan.
authors.forename: Katsuhisa
authors.initials: K
authors.lastname: Banno
authors.forename: Clare
authors.initials: C
authors.lastname: Ramsey
authors.forename: Randy
authors.initials: R
authors.lastname: Walld
authors.forename: Meir H
authors.initials: MH
authors.lastname: Kryger
mesh_terms: D015992:Body Mass Index; D005251:Fees, Medical / Q000706:statistics & numerical data; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data; D005102:Health Expenditures / Q000706:statistics & numerical data*; D006296:Health Services / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D008350:Manitoba; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000191:economics*; D010845:Obesity Hypoventilation Syndrome / Q000191:economics* / Q000628:therapy; D012017:Referral and Consultation / Q000191:economics / Q000706:statistics & numerical data; D020181:Sleep Apnea, Obstructive / Q000191:economics* / Q000628:therapy; D014600:Utilization Review / Q000706:statistics & numerical data