Association of body mass index categories with healthcare use and health expenditures in Switzerland: a cross-sectional, community-based study

Abstract

BACKGROUND: Increased body mass index (BMI) is associated with increased medical costs, but no information is available for Switzerland. We investigated the association of individual BMI categories with healthcare use and healthcare expenditures. METHODS: Data from an ongoing prospective, community-based study conducted in Lausanne, Switzerland. Information on healthcare use, type of insurance and deductible level were provided by the participants for period 2018-2021. Health expenditures were obtained from health insurers. RESULTS: 1960 participants (64.5 ± 9.6 years, 50.4% women) had data on healthcare use. After multivariable adjustment on socioeconomic and health covariates, participants with obesity were less likely to use complementary medicines or over the counter drugs, odds ratio and (95% confidence interval): 0.74 (0.56-0.98) and 0.61 (0.44-0.85), respectively, while being more likely to be on polypharmacy [1.52 (1.05-2.20)] and benefitting from home care [2.25 (1.19-4.25)]. 907 participants (64.4 ± 9.4 years, 48.6% women) had data on health expenditures. BMI levels were positively associated with total health expenditures (median and [interquartile range]: 3740 [1717-7935], 2815 [666-6170] and 1680 [248-4975] CHF for obesity, overweight and normal weight, respectively, p < 0.001) and expenditures paid by insurance (3189 [820-7262], 2179 [0-5604] and 1019 [0-4205] CHF, respectively, p < 0.001). After multivariable adjustment, participants with obesity still presented higher total expenditures, while no difference was found for insurance-paid expenditures or participants with overweight. CONCLUSION: People with obesity have higher healthcare use and higher total health expenditures than people with normal weight.