Purpose: To estimate health care expenditures associated with obesity-related diseases (ORDs), including diabetes, hypertension, coronary heart disease (CHD), and stroke.
Methods: Data from the National Health Interview Survey (NHIS), 1997-2000, were linked to the Medical Expenditure Panel Survey (MEPS). Our sample was chosen from the NHIS Sample Adult Data Files, which contain data on adults aged 18 years and older. The main outcome variable was total health care expenditures. Expenditures in MEPS are defined as payments from all sources, including direct payments from individuals, private insurance, Medicare, Medicaid, and miscellaneous other sources. Our analyses were stratified by gender and adjusted for age, age squared, inverted body mass index, marital status, smoking, race, and physical activity. Total expenditures were projected based on the regression estimates. All expenditures were computed at the 2000 price level based on the Consumer Price Index for All Urban Consumers. Bootstrap was performed to resample the population 1,000 times to compute the means and standard errors. The complex sampling designs in the NHIS and MEPS were adjusted from data merging and analysis to total expenditure prediction.
Results: Our sample comprised 17,917 women and 13,928 men. The total expenditures (standard errors) for men with hypertension, diabetes, CHD, and stroke were $5,570 ($262), $7,729 ($441), $9,600 ($644), and $10,865 ($1,096) per person, respectively. The total expenditures for women were higher than those for men: $5,899 ($212) for hypertension, $9,286 ($531) for diabetes, $10,205 ($941) for stroke, and $10,480 ($867) for CHD. However, men with hypertension, diabetes, CHD, and stroke had 3.1, 4.3, 5.4, and 6.1 times more expenditures than men without any of these ORDs, while the relative expenditure ratios for women with hypertension (2.3), diabetes (3.6), CHD (4.1), and stroke (4.0) were lower as compared to women without ORDs.
Conclusions: This study provides evidence suggesting that total health care expenditures were higher for women with and without ORDs than for men. Among the total health care expenditures for women and men with ORDs, women with CHD and men with stroke had the highest expenditures. Women with or without these ORDs had higher health care expenditures than men, except for the total expenditures for people with stroke. Nonetheless, relative expenditures comparing those with ORDs to those without are higher for men than for women.
