title: Preventing Obesity in the USA: Impact on Health Service Utilization and Costs.
abstract: BACKGROUND
  With more than two-thirds of the US population overweight or obese, the obesity epidemic is a major threat for population health and the financial sustainability of the healthcare service. Whether, and to what extent, effective prevention interventions may offer the opportunity to 'bend the curve' of rising healthcare costs is still an object of debate.
  
  
  OBJECTIVE
  This study evaluates the potential economic impact of a set of prevention programmes, including education, counselling, long-term drug treatment, regulation (e.g. of advertising or labelling) and fiscal measures, on national healthcare expenditure and use of healthcare services in the USA.
  
  
  METHODS
  The study was carried out as a retrospective evaluation of alternative scenarios compared with a 'business as usual' scenario. An advanced econometric approach involving the use of logistic regression and generalized linear models was used to calculate the number of contacts with key healthcare services (inpatient, outpatient, drug prescriptions) and the associated cost. Analyses were carried out on the Medical Expenditure Panel Survey (1997-2010).
  
  
  RESULTS
  In 2010, prevention interventions had the potential to decrease total healthcare expenditure by up to $US2 billion. This estimate does not include the implementation costs. The largest share of savings is produced by reduced use and costs of inpatient care, followed by reduced use of drugs. Reduction in expenditure for outpatient care would be more limited. Private insurance schemes benefit from the largest savings in absolute terms; however, public insurance schemes benefit from the largest cost reduction per patient. People in the lowest income groups show the largest economic benefits.
  
  
  CONCLUSIONS
  Prevention interventions aimed at tackling obesity and associated risk factors may produce a significant decrease in the use of healthcare services and expenditure. Savings become substantial when a long-term perspective is taken.
authors.affiliation: Institute of Global Health Innovation, Imperial College London, London, UK, michele.cecchini@oecd.org.
authors.forename: Michele
authors.initials: M
authors.lastname: Cecchini
authors.forename: Franco
authors.initials: F
authors.lastname: Sassi
mesh_terms: D017048:Health Care Costs; D005102:Health Expenditures; D006801:Humans; D009765:Obesity / Q000191:economics / Q000517:prevention & control*; D011314:Preventive Health Services / Q000191:economics / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D014481:United States