The impact of obesity on health care costs among persons with schizophrenia

Lydia A. Chwastiak, Robert A. Rosenheck, Joseph Patrick McEvoy, T. Scott Stroup, Marvin S. Swartz, Sonia M. Davis, Jeffrey A. Lieberman

Research output: Contribution to journalArticle

31 Citations (Scopus)

Abstract

Background: Obesity is the second leading cause of preventable death in the United States and is twice as common among individuals with schizophrenia as the general population. Methods: Data from the Clinical Antipsychotic Trials of Intervention Effectiveness, a multisite trial of antipsychotic pharmacotherapy in 1460 patients with schizophrenia, were used to examine the relationships between body mass index (BMI) and medical costs. Results: ANCOVA analyses found significant increases in both psychiatric and nonpsychiatric medication costs associated with increasing BMI and a significant, but smaller, difference in costs of outpatient medical-surgical service utilization: US$41 per month for morbidly obese patients compared to US$26 per month for patients of normal weight (F=2.4, P=.04). In multivariable logistic regression analyses, morbid obesity was associated with significantly increased odds of any outpatient medical-surgical service costs. When compared to observations of BMI>35, BMI observations within the normal range (18.5-24.9) were half as likely to be associated with any outpatient medical-surgical costs (OR=0.53; 95% CI=0.45, 0.63). Conclusions: In this large sample of persons with schizophrenia, obesity was associated with increased outpatient general medical service and medication costs even after controlling for demographic characteristics and medical comorbidity, but the absolute dollar amount was small.

Original languageEnglish (US)
Pages (from-to)1-7
Number of pages7
JournalGeneral Hospital Psychiatry
Volume31
Issue number1
DOIs
StatePublished - Jan 1 2009

Fingerprint

Health Care Costs
Schizophrenia
Obesity
Costs and Cost Analysis
Body Mass Index
Outpatients
Antipsychotic Agents
Morbid Obesity
Psychiatry
Comorbidity
Cause of Death
Reference Values
Logistic Models
Regression Analysis
Demography
Clinical Trials
Weights and Measures
Drug Therapy
Population

Keywords

  • Cost
  • Obesity
  • Schizophrenia

ASJC Scopus subject areas

  • Psychiatry and Mental health

Cite this

Chwastiak, L. A., Rosenheck, R. A., McEvoy, J. P., Stroup, T. S., Swartz, M. S., Davis, S. M., & Lieberman, J. A. (2009). The impact of obesity on health care costs among persons with schizophrenia. General Hospital Psychiatry, 31(1), 1-7. https://doi.org/10.1016/j.genhosppsych.2008.09.012

The impact of obesity on health care costs among persons with schizophrenia. / Chwastiak, Lydia A.; Rosenheck, Robert A.; McEvoy, Joseph Patrick; Stroup, T. Scott; Swartz, Marvin S.; Davis, Sonia M.; Lieberman, Jeffrey A.

In: General Hospital Psychiatry, Vol. 31, No. 1, 01.01.2009, p. 1-7.

Research output: Contribution to journalArticle

Chwastiak, LA, Rosenheck, RA, McEvoy, JP, Stroup, TS, Swartz, MS, Davis, SM & Lieberman, JA 2009, 'The impact of obesity on health care costs among persons with schizophrenia', General Hospital Psychiatry, vol. 31, no. 1, pp. 1-7. https://doi.org/10.1016/j.genhosppsych.2008.09.012
Chwastiak, Lydia A. ; Rosenheck, Robert A. ; McEvoy, Joseph Patrick ; Stroup, T. Scott ; Swartz, Marvin S. ; Davis, Sonia M. ; Lieberman, Jeffrey A. / The impact of obesity on health care costs among persons with schizophrenia. In: General Hospital Psychiatry. 2009 ; Vol. 31, No. 1. pp. 1-7.
@article{57320a8dd8a6448fb76b7ccb847a5b4f,
title = "The impact of obesity on health care costs among persons with schizophrenia",
abstract = "Background: Obesity is the second leading cause of preventable death in the United States and is twice as common among individuals with schizophrenia as the general population. Methods: Data from the Clinical Antipsychotic Trials of Intervention Effectiveness, a multisite trial of antipsychotic pharmacotherapy in 1460 patients with schizophrenia, were used to examine the relationships between body mass index (BMI) and medical costs. Results: ANCOVA analyses found significant increases in both psychiatric and nonpsychiatric medication costs associated with increasing BMI and a significant, but smaller, difference in costs of outpatient medical-surgical service utilization: US$41 per month for morbidly obese patients compared to US$26 per month for patients of normal weight (F=2.4, P=.04). In multivariable logistic regression analyses, morbid obesity was associated with significantly increased odds of any outpatient medical-surgical service costs. When compared to observations of BMI>35, BMI observations within the normal range (18.5-24.9) were half as likely to be associated with any outpatient medical-surgical costs (OR=0.53; 95{\%} CI=0.45, 0.63). Conclusions: In this large sample of persons with schizophrenia, obesity was associated with increased outpatient general medical service and medication costs even after controlling for demographic characteristics and medical comorbidity, but the absolute dollar amount was small.",
keywords = "Cost, Obesity, Schizophrenia",
author = "Chwastiak, {Lydia A.} and Rosenheck, {Robert A.} and McEvoy, {Joseph Patrick} and Stroup, {T. Scott} and Swartz, {Marvin S.} and Davis, {Sonia M.} and Lieberman, {Jeffrey A.}",
year = "2009",
month = "1",
day = "1",
doi = "10.1016/j.genhosppsych.2008.09.012",
language = "English (US)",
volume = "31",
pages = "1--7",
journal = "General Hospital Psychiatry",
issn = "0163-8343",
publisher = "Elsevier Inc.",
number = "1",

}

TY - JOUR

T1 - The impact of obesity on health care costs among persons with schizophrenia

AU - Chwastiak, Lydia A.

AU - Rosenheck, Robert A.

AU - McEvoy, Joseph Patrick

AU - Stroup, T. Scott

AU - Swartz, Marvin S.

AU - Davis, Sonia M.

AU - Lieberman, Jeffrey A.

PY - 2009/1/1

Y1 - 2009/1/1

N2 - Background: Obesity is the second leading cause of preventable death in the United States and is twice as common among individuals with schizophrenia as the general population. Methods: Data from the Clinical Antipsychotic Trials of Intervention Effectiveness, a multisite trial of antipsychotic pharmacotherapy in 1460 patients with schizophrenia, were used to examine the relationships between body mass index (BMI) and medical costs. Results: ANCOVA analyses found significant increases in both psychiatric and nonpsychiatric medication costs associated with increasing BMI and a significant, but smaller, difference in costs of outpatient medical-surgical service utilization: US$41 per month for morbidly obese patients compared to US$26 per month for patients of normal weight (F=2.4, P=.04). In multivariable logistic regression analyses, morbid obesity was associated with significantly increased odds of any outpatient medical-surgical service costs. When compared to observations of BMI>35, BMI observations within the normal range (18.5-24.9) were half as likely to be associated with any outpatient medical-surgical costs (OR=0.53; 95% CI=0.45, 0.63). Conclusions: In this large sample of persons with schizophrenia, obesity was associated with increased outpatient general medical service and medication costs even after controlling for demographic characteristics and medical comorbidity, but the absolute dollar amount was small.

AB - Background: Obesity is the second leading cause of preventable death in the United States and is twice as common among individuals with schizophrenia as the general population. Methods: Data from the Clinical Antipsychotic Trials of Intervention Effectiveness, a multisite trial of antipsychotic pharmacotherapy in 1460 patients with schizophrenia, were used to examine the relationships between body mass index (BMI) and medical costs. Results: ANCOVA analyses found significant increases in both psychiatric and nonpsychiatric medication costs associated with increasing BMI and a significant, but smaller, difference in costs of outpatient medical-surgical service utilization: US$41 per month for morbidly obese patients compared to US$26 per month for patients of normal weight (F=2.4, P=.04). In multivariable logistic regression analyses, morbid obesity was associated with significantly increased odds of any outpatient medical-surgical service costs. When compared to observations of BMI>35, BMI observations within the normal range (18.5-24.9) were half as likely to be associated with any outpatient medical-surgical costs (OR=0.53; 95% CI=0.45, 0.63). Conclusions: In this large sample of persons with schizophrenia, obesity was associated with increased outpatient general medical service and medication costs even after controlling for demographic characteristics and medical comorbidity, but the absolute dollar amount was small.

KW - Cost

KW - Obesity

KW - Schizophrenia

UR - http://www.scopus.com/inward/record.url?scp=58149197909&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=58149197909&partnerID=8YFLogxK

U2 - 10.1016/j.genhosppsych.2008.09.012

DO - 10.1016/j.genhosppsych.2008.09.012

M3 - Article

C2 - 19134502

AN - SCOPUS:58149197909

VL - 31

SP - 1

EP - 7

JO - General Hospital Psychiatry

JF - General Hospital Psychiatry

SN - 0163-8343

IS - 1

ER -