title: Medical services utilization and expenditure of obesity-related disorders in Taiwanese adults.
abstract: OBJECTIVE
  To evaluate medical service utilization and medical expenditure associated with obesity-related diseases among different weight status subjects in Taiwan.
  
  
  METHODS
  A cross-sectional survey based on the National Health Interview Survey performed in 2001. Subjects greater than 20 years old who lived in Taiwan, as corroborated by National Health Insurance (NHI), during 2001, were included. Overall, the data set included 15,461 subjects with age of 20-85 years old. After excluding those subjects with incomplete or missing data or who refused to link their data with the NHI data, 12,283 subjects were used for analyses.
  
  
  RESULTS
  In general, obesity-related disorders, such as hypertension, diabetes mellitus (DM), and cardiovascular diseases have increasing prevalence with greater body mass index (BMI; P<0.001). Obese subjects (BMI≧27kg/m(2) ) had the highest prevalence of hypertension (31.9%), after DM (26.9%). After adjusting for age, smoking, drinking and obesity-related disorders, it was found that medical utilization in outpatient increases from 1.33 to 4.04 visits/year (P<0.001) and in-hospital increases from 0.05 to 0.07 admissions/year (P>0.05) with higher BMI. Average outpatient expenditure (including physician fee, laboratory test and drug costs) per year is NT$1201, 1857, 3960, and 5118 (at an exchange rate of NT$32 to US$1) for underweight, normal, overweight, and obese subjects, respectively (P<0.001).
  
  
  CONCLUSIONS
  Medical utilization and outpatient medical expenditure was found to increase with higher BMI status. However, there was a J-shaped (in female) or even negative (in male) relationship between BMI and in-hospital medical expenditures. Further studies are needed to resolve this major public health problem, even in a developing country such as Taiwan.
authors.affiliation: School of Public Health, National Defense Medical Center, Taipei, Taiwan. chuepi@ndmctsgh.edu.tw
authors.forename: Nain-Feng
authors.initials: NF
authors.lastname: Chu
authors.forename: Shu-Chuan
authors.initials: SC
authors.lastname: Wang
authors.forename: Hsin-Yi
authors.initials: HY
authors.lastname: Chang
authors.forename: Der-Min
authors.initials: DM
authors.lastname: Wu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D005102:Health Expenditures; D006296:Health Services / Q000191:economics / Q000706:statistics & numerical data*; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D009313:National Health Programs / Q000191:economics / Q000706:statistics & numerical data; D009765:Obesity / Q000150:complications / Q000191:economics* / Q000453:epidemiology; D015995:Prevalence; D012737:Sex Factors; D013624:Taiwan / Q000453:epidemiology; D055815:Young Adult