Exploring the Impact of Obesity on Health Care Resources and Coding in the Acute Hospital Setting: A Feasibility Study.

Winnie S Y Tan,Merrilyn Banks,Tracy Comans,Alexandra L Di Bella,Adrienne M Young

doi:10.3390/healthcare8040459

Abstract

Obesity is costly, yet there have been few attempts to estimate the actual costs of providing hospital care to the obese inpatient. This study aimed to test the feasibility of measuring obesity-related health care costs and accuracy of coding data for acute inpatients. A prospective observational study was conducted over three weeks in June 2018 in a single orthopaedic ward of a metropolitan tertiary hospital in Queensland, Australia. Demographic data, anthropometric measurements, clinical characteristics, cost of hospital encounter and coding data were collected. Complete demographic, anthropometric and clinical data were collected for all 18 participants. Hospital costing reports and coding data were not available within the study timeframe. Participant recruitment and data collection were resource-intensive, with mobility assistance required to obtain anthropometric measurements in more than half of the participants. Greater staff time and costs were seen in participants with obesity compared to those without obesity (obesity: body mass index ≥ 30), though large standard deviations indicate wide variance. Data collected suggest that obesity-related cost and resource use amongst acute inpatients require further exploration. This study provides recommendations for protocol refinement to improve the accuracy of data collected for future studies measuring the actual cost of providing hospital care to obese inpatients.

Highlights

Over half of the current population is either overweight or obese, with current obesity rates nearly tripling since 1975 [1]
Mean body mass index (BMI) was 28.7 kg/m2 (SD: 7.7, range: 19.1–45.9 kg/m2 ); with six participants (33%) classified as obese according to BMI and nine (53%) classified as obese according to WC
By identifying specific aspects of inpatient cost that increase due to obesity, important targeted cost-saving strategies can be implemented by hospitals to address this economic burden effectively and ensure appropriate remuneration

Summary

Introduction

Over half of the current population is either overweight or obese, with current obesity rates nearly tripling since 1975 [1]. The prevalence of obesity is significant in Australia, where about one-third of the current adult population is obese [2]. This is a major public health concern as obesity is a known risk factor for various comorbidities including diabetes [3,4], non-alcoholic fatty liver disease [5,6], and cardiovascular diseases [7]. Available evidence determined that health care costs and length of stay (LOS) of patients are positively associated with increasing body mass index (BMI) [10,11,12,13,14,15].

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Methods

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Discussion

Conclusion