Healthcare usage and economic impact of non-treated obesity in Italy: findings from a retrospective administrative and clinical database analysis

BMJ Open. 2017 Feb 24;7(2):e013899. doi: 10.1136/bmjopen-2016-013899.

Abstract

Objectives: Investigate the prevalence of obesity in Italy and examine its resource consumption and economic impact on the Italian national healthcare system (NHS).

Design: Retrospective, observational and real-life study.

Setting: Data from three health units from Northern (Bergamo, Lombardy), Central (Grosseto, Tuscany) and Southern (Naples, Campania) Italy.

Participants: All patients aged ≥18 years with at least one recorded body mass index (BMI) measurement between 1 January 2009 and 31 December 2012 were included.

Interventions: Information retrieved from the databases included primary care data, medical prescriptions, specialist consultations and hospital discharge records from 2009-2013. Costs associated with these data were also calculated. Data are presented for two time periods (1 year after BMI measurement and study end).

Primary and secondary outcome measures: Primary-to estimate health resources consumption and the associated economic impact on the Italian NHS. Secondary-the prevalence and characteristics of subjects by BMI category.

Results: 20 159 adult subjects with at least one documented BMI measurement. Subjects with BMI ≥30 kg/m2 were defined as obese. The prevalence of obesity was 22.2% (N=4471) and increased with age. At the 1-year observation period, obese subjects who did not receive treatment for their obesity experienced longer durations of hospitalisation (median length: 5 days vs 3 days), used more prescription drugs (75.0% vs 57.7%), required more specialised outpatient healthcare (mean number: 5.3 vs 4.4) and were associated with greater costs, primarily owing to prescription drugs and hospital admissions (mean annual cost per year per patient: €460.6 vs €288.0 for drug prescriptions, €422.7 vs € 279.2 for hospitalisations and €283.2 vs €251.7 for outpatient care), compared with normal weight subjects. Similar findings were observed for the period up to data cut-off (mean follow-up of 2.7 years).

Conclusions: Untreated obesity has a significant economic impact on the Italian healthcare system, highlighting the need to raise awareness and proactively treat obese subjects.

Keywords: Body mass index; Healthcare resource consumption; Obesity; Real-life study; Retrospective.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Age Distribution
  • Aged
  • Body Mass Index
  • Databases, Factual
  • Drug Prescriptions / economics*
  • Drug Prescriptions / statistics & numerical data
  • Female
  • Health Care Costs*
  • Hospitalization / economics*
  • Hospitalization / statistics & numerical data
  • Humans
  • Italy / epidemiology
  • Male
  • Middle Aged
  • Obesity / epidemiology*
  • Prevalence
  • Primary Health Care / economics*
  • Retrospective Studies
  • Sex Distribution
  • Young Adult