title: Determining the cost of obesity and its common comorbidities from a commercial claims database.
abstract: What is already known about this subject Obesity is highly prevalent and costly in the US. Obesity often leads to other comorbid conditions, including diabetes and hypertension. Obesity prevention efforts can reduce healthcare costs. What this study adds Obesity combined with other comorbidities significantly increases healthcare costs per patient visit. The combination of obesity and depression exacerbates costs. The most expensive series of chronic conditions in this study included obesity, diabetes, hypertension and depression. Our objectives were to determine payments made by commercial healthcare providers in the US for adults diagnosed with obesity, and those comorbid with any combination of selected chronic conditions. Using a commercial claims and encounters database (n = 3,562,717), we evaluated an adult study population that had at least one in-patient visit, outpatient visit or emergency department visit, and received a primary or secondary diagnosis of obesity. Persons were categorized by one or more comorbid diagnoses for diabetes mellitus, hypertension, depression or congestive heart failure. We adjusted for age and gender, and calculated the mean total net expenditures (in 2012, $US) for each combination of comorbid conditions based on individual visits to an in-patient, outpatient or emergency department setting. Among 50,717 claims with diagnosis of obesity, the mean net expenditure for in-patient and outpatient services was $ 1907 per patient per visit. Persons diagnosed with obesity and other comorbidities observed an increase in total net expenditures. Obesity and congestive heart failure observed the highest increase among single comorbidities at $ 5275. For persons with obesity and two other comorbidities, diabetes mellitus and depression was the highest at $ 15,226. The most expensive condition was obesity, diabetes mellitus, hypertension and depression at $ 15,733. Compared with average medical claims, persons diagnosed with obesity and other common chronic conditions experience significant increases in medical costs. These costs are often driven higher by time spent as in-patients. By controlling and reducing the prevalence of obesity, we may see significant decreases in medical expenditures.
authors.affiliation: Section of Hospital Medicine, University of Chicago, Chicago, IL, USA.
authors.forename: W V
authors.initials: WV
authors.lastname: Padula
authors.forename: R R
authors.initials: RR
authors.lastname: Allen
authors.forename: K V
authors.initials: KV
authors.lastname: Nair
mesh_terms: D000328:Adult; D015897:Comorbidity; D017281:Cost of Illness; D016208:Databases, Factual; D003863:Depression / Q000191:economics* / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000191:economics* / Q000453:epidemiology; D005260:Female; D006333:Heart Failure / Q000191:economics* / Q000453:epidemiology; D006801:Humans; D006973:Hypertension / Q000191:economics* / Q000453:epidemiology; D007345:Insurance Claim Review; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000191:economics* / Q000453:epidemiology; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology
keywords: Comorbidity; commercial claims; cost; obesity