Obesity and healthcare resource utilization: results from Clinical Practice Research Database (CPRD).

BACKGROUND/OBJECTIVES: The economic burden of obesity and type 2 diabetes (T2D) rises with increasing prevalence. This study estimates the association between obesity, healthcare resource utilization (HCRU) and associated costs in individuals with/without T2D. SUBJECTS/METHODS: This observational cohort study used the United Kingdom Clinical Practice Research Datalink data. Between 1 January 2011 and 31 December 2015, total HCRU costs and individual component costs (hospitalizations, general practitioner contacts, prescriptions) were calculated for individuals linked to the Hospital Episodes Statistics database with/without T2D with normal weight, overweight, class I, II, III obesity. RESULTS: A total of 396,091 individuals were included. Increasing body mass index (BMI) was associated with increased HCRU costs. At each BMI category, costs were greater for individuals with than without T2D. Relative to normal BMI, increasing BMI was positively associated with increased HCRU costs, with similar magnitude regardless of T2D. The total HCRU cost for an individual with class III obesity was 1.4-fold (£3,695) greater than for normal weight. CONCLUSION: In the United Kingdom, HCRU costs were positively associated with increasing BMI, irrespective of T2D status. The combination of T2D and obesity was associated with higher HCRU costs compared with individuals of the same BMI, without T2D. These findings suggest that prioritizing weight management programmes focused specifically on individuals with obesity and T2D may be more cost-effective than for those with obesity alone.

Obesity and healthcare resource utilization: comparative results from the UK and the USA.

Objectives: To estimate the differences between individuals with and without obesity on healthcare resource utilization using two large electronic medical record databases. Methods: Data from the UK Clinical Practice Research Datalink and US General Electric Centricity database of adults (≥18 years) with registration date before 01/01/2010. Differences between individuals with and without obesity on 5-year rates of Primary Care Physician (PCP) contacts, prescriptions and hospitalizations were analysed. Results: The study contained 1,878,017 UK and 4,414,883 US individuals. Compared with body mass index (BMI) (18.5-24.9 kg m-2), significant (p < 0.0001) increases in healthcare usage were observed with increasing BMI. Individuals with BMI 30-34.9 kg m-2 had higher PCP contact rate (rate ratios [RR] 1.27 and 1.28 for UK and USA, respectively), higher prescription rate (RR 1.61 and 1.51) and higher hospitalization rate (RR 1.10 and 1.13) than individuals with BMI 18.5-24.9 kg m-2. Individuals with BMI >40 kg m-2 also had higher PCP contact rate (RR 1.56 and 1.64), prescription rate (RR 2.48 and 2.14) and hospitalization rate (RR 1.27 and 1.30) than individuals with BMI 18.5-24.9 kg m-2. Conclusions: The utilization of healthcare resources is significantly higher in individuals with obesity. A similar trend was observed in both the UK and US cohorts.

Output of histamine chloride from 7 nebulizers.

The aim of the study was to assess the amount of aerosol delivered by seven different nebulizers. Six of the nebulizers were supplied by an airstream of 7.5 l/min and the seventh (Pari Inhalierboy) connected to a compressor supplying an airstream of 15 l/min. The nebulizer plus solution was weighed before and after one min of nebulization. In this way the amount of aerosol delivered was measured ten times for each nebulizer. Results are given as mean values +/- SD (gram/min): Hudson nebulizer model no. 2720: 0.2950 +/- 0.0154, Mefar Respi-Neb: 0.3574 +/- 0.0100, Sandoz: 0.4399 +/- 0.0201, VIx: 0.2824 +/- 0.0121, Acorn: 0.3619 +/- 0.0088, Pari Inhalierboy: 0.4865 +/- 0.0105, Raindrop: 0.2668 +/- 0.0082. Standard deviation calculated as per cent of the average were: Hudson nebulizer model no. 1720: 5.22%, Mefar Respi-Neb: 2.80%, Sandoz: 4.57% Vix: 4.28%, Acorn 2.43%, Pari Inhalierboy: 2.16%, Raindrop: 3.00%. Per cent variation between the products giving Hudson 100%: Mefar Respi-Neb: +18.77, Sandoz +46.19, Vix: -6.14, Acorn: +20.27, Pari Inhalierboy: +61.68, Raindrop: -9.56. The Hudson nebulizer was also tested with three different volumes of histamine chloride: 2 ml, 3 ml, and 4 ml. The mean values +/- SD (gram/min) for the aerosols were: 2 ml: 0.2986 +/- 0.0071, 3 ml: 0.2981 +/- 0.0080 and 4 ml: 0.2976 +/- 0.0056. The mean value of output from ten different Hudson nebulizers +/- SD was: 0.2767 +/- 0.0105 gram/min.