title: The Impact of Severe Obesity on Healthcare Resource Utilisation in Spain.
abstract: Obesity is not only a health problem but also a source of increased monetary expenditures. The objectives of this study were to analyse the use of healthcare resources in the Spanish adult population with class II obesity and above (BMI ≥35 kg/m2) and to compare it with other BMI groups.
  
  
  
  We used the Spanish National Health Survey, a longitudinal population-based survey (n = 18,682), to analyse healthcare resource utilisation by BMI groups. Adjusted and unadjusted logistic regression models were used to calculate odds ratios (OR) for healthcare use among class II and over obese subjects versus normal BMI.
  
  
  
  Persons with BMI ≥35 are more likely to attend general practitioner (GP)'s consultations (17%), to visit the emergency department (26%), to consume medications (36%), to be hospitalised (49%), to require nursing consultations (61%) and to require psychology consultations (83%). The proportion of obese people receiving home visits is 2.6 times higher than among normal BMI. After controlling for sex and age groups, people with severe obesity (BMI ≥35 kg/m2) were more prone to requiring home care visits (OR 2.3; CI [1.3; 4.2]), GP visits (OR 2.1; CI [1.5; 3.0]), psychologist visits (OR 1.96; CI [1.3; 2.99]), emergency service visits (OR 1.5; CI [1.2; 1.8]), nurse visits (OR 1.46; CI [1.2; 1.9]) and hospitalisations (OR 1.43; CI [1.1; 1.9]) and after also adjusting for relevant comorbidities like hypertension, diabetes and cardiovascular diseases: GP visits (OR 1.85; CI [1.3; 2.7]), psychologist visits (OR 1.8; CI [1.2; 2.7]), specialised care visits (OR 0.92; CI [0.7; 1.2]) and physiotherapist visits (OR 0.7; CI [0.5; 1.0]).
  
  
  
  Severe obesity significantly increases healthcare resource utilisation in Spain. The results shed light on the real magnitude of the burden of obesity in Spain.
authors.affiliation: Seminario de Investigación en Economía y Salud, University of Castilla-La Mancha, Toledo, Spain.
authors.forename: Olga
authors.initials: O
authors.lastname: Espallardo
authors.affiliation: Seminario de Investigación en Economía y Salud, University of Castilla-La Mancha, Toledo, Spain.
authors.forename: Rafael
authors.initials: R
authors.lastname: Busutil
authors.affiliation: Hospital Clínico de San Carlos, Madrid, Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: Torres
authors.affiliation: Instituto Max Weber, Majadahonda, Madrid, Spain. neboa.zozaya@imw.es.
authors.forename: Néboa
authors.initials: N
authors.lastname: Zozaya
authors.affiliation: Instituto Max Weber, Majadahonda, Madrid, Spain.
authors.forename: Renata
authors.initials: R
authors.lastname: Villoro
authors.affiliation: University of Castilla-La Mancha, Toledo, Spain.
authors.forename: Álvaro
authors.initials: Á
authors.lastname: Hidalgo-Vega
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D005260:Female; D005102:Health Expenditures / Q000706:statistics & numerical data; D006295:Health Resources / Q000706:statistics & numerical data*; D006306:Health Surveys; D006760:Hospitalization / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000191:economics* / Q000453:epidemiology*; D016017:Odds Ratio; D013030:Spain / Q000453:epidemiology
keywords: BMI; Healthcare resources; Obesity; Spain