Changing BMI Categories and Healthcare Expenditures Among Elderly Medicare Beneficiaries

• Published in: Obesity (Silver Spring, Md.) Vol. 20; no. 6; pp. 1240 - 1248
• Main Authors: Wilkins, Tricia Lee, Rust, George S., Sambamoorthi, Usha
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01-06-2012
• Subjects: Adult; Aged; Body Mass Index; Female; Health care expenditures; Health Expenditures - statistics & numerical data; Humans; Longitudinal Studies; Male; Medicare; Medicare - economics; Medicare - statistics & numerical data; Middle Aged; Obesity - complications; Obesity - economics; Obesity - epidemiology; Older people; United States - epidemiology; Weight Loss; United States
• ISSN: 1930-7381; 1930-739X
• DOI: 10.1038/oby.2011.86

To examine the association between changes in BMI categories and health‐care expenditures among elderly Medicare beneficiaries using longitudinal data of the Medicare Current Beneficiary Survey (MCBS) 2000–2005. Changes in BMI were (i) Stayed Normal: individuals with a normal BMI at baseline and follow‐up; (ii) Stayed Overweight individuals with overweight BMI at baseline and follow‐up; (iii) Stayed Obese individuals with obese BMI at baseline and follow‐up; (iv) Normal‐Overweight: individuals with normal BMI at baseline and overweight BMI at follow‐up; (v) Overweight‐Obese: individuals with overweight BMI at baseline and obese BMI at follow‐up; (vi) Overweight‐Normal: individuals with overweight BMI at baseline and normal BMI at follow‐up; (vii) Obese‐Overweight: individuals with obese BMI at baseline and overweight BMI at follow‐up. Ordinary Least Squares (OLS) models on logged Year 3 expenditures were used to analyze changes in expenditures between BMI categories. Overall, 35% Stayed Normal, 34% Stayed Overweight, 18% Stayed Obese, 4% gained weight from Normal‐Overweight BMI, 3% gained weight from Overweight‐Obese BMI, 5% lost weight from Overweight‐Normal BMI, and 3% lost weight from Obese‐Overweight BMI. Adjusted models revealed those who Stayed Obese had increased total and multiple expenditure types that were significantly higher than Stayed Normal including total (11%), outpatient (25%), prescription (9%), and medical provider (4%). Compared to Stayed Normal, total expenditures were both 26% higher for Obese‐Overweight and Overweight‐Obese. The current findings highlight the importance of maintaining a normal BMI in the elderly.