Obese older adults have higher rate of hospitalizations, ER admissions

Obesity is associated with substantial increases in older adults' hospitalizations, emergency room admissions and use of outpatient health care services, according to a new study of 172,866 Medicare Advantage members throughout the U.S. Results of the one-year study will be presented Thursday at the Endocrine Society's 97th annual meeting in San Diego.

"There is an urgent need to control the obesity epidemic and its excessive health and economic burden on both individuals and the health care system," said lead investigator Brandon Suehs, PharmD, PhD, a research leader at Comprehensive Health Insights, a research company of Humana based in Louisville, Ky.

Nearly one-third of Americans have obesity, which is linked to an increased risk of Type 2 diabetes, heart disease and other chronic conditions.

The investigators evaluated the impact of seniors' obesity on utilization of health care resources in a one-year period. They used diagnostic codes on medical claims to classify subjects into categories of body mass index (BMI), which Suehs said is unique.

"These readily available administrative data may be useful for directing obesity interventions to health plan members at greatest risk for obesity and obesity-related diseases," he commented.

The study was conducted as part of a research collaboration between Humana and Novo Nordisk, which funded the study.

The researchers excluded underweight adults from their study of 172,866 Humana Medicare Advantage members ages 65 and older. The participants' BMI classes (in kg/m2), and the approximate (rounded) percentage of this patient population that fell into each class, were:

• Normal weight: BMI of 19 to 24.9 (21 percent)
• Overweight: 25 to 29.9 (37 percent)
• Moderately obese: 30 to 34.9 (24 percent)
• Severely obese: 35 to 39.9 (10 percent)
• Very severely (also called morbidly) obese: 40 or higher (9 percent)

Statistical analyses found that the most severely obese group had 3.4 times the odds of having an inpatient admission during the year and 1.4 times the odds of going to the emergency room, compared with the healthy-weight group. Additionally, this very severely obese group (class III obesity, according to the World Health Organization) had a 10 percent higher rate of using outpatient services, Suehs reported.

The other two obesity groups also had a greater chance of using health care resources, with the odds increasing as the BMI class increased, the study abstract showed.

Medication use was higher in obese patients as well. The number of different medications prescribed for conditions that often relate to obesity, such as high blood pressure, high cholesterol, high blood sugar, pain and depression, rose as the BMI class increased, according to an analysis of claims for prescription medications ordered before the study started.

Suehs said, "We hope the study results inform broader obesity prevention strategies to improve the health of seniors."