A healthcare cost model study that was designed to estimate the total secondary care costs of patients by body mass index (BM) category - when hospitalised due to COVID‐19 in Europe (during the first wave of the pandemic from January to June 2020) - has reported excess weight contributed disproportionally to the costs of COVID‐19. The outcomes were reported in the paper, ‘Costs of the COVID‐19 pandemic associated with obesity in Europe: A health‐care cost model’, published in Clinical Obesity.
For the study, European researchers calculated the average cost per patient and in total based on risks of admission to ICU, risk of invasive mechanical ventilation (IMV) and length of hospital stay when hospitalised and published costs associated with hospitalisation. The primary care costs (visits to a general practitioner or an associated healthcare professional with associated treatments, and indirect costs ie. lost productivity during illness) were not included in the analysis. Cost estimations were based on publicly available costs from Denmark, France, Spain and the UK.
They reported that in Europe, more than 720 547 people were admitted to hospital for COVID‐19 from the beginning of January 2020 and the end June, and findings based on their modelling suggests that 71% of all patients admitted to the hospital with COVID‐19 had overweight, of whom 35% were living with obesity. In addition to having a higher probability of being admitted to a general hospital with COVID‐19, those with obesity also have a higher probability of being admitted to ICU and ICU + IMV compared with people with BMI<25 kg/m2. The average costs of a hospital bed day (ie, 24 hours) for a general hospital admission, an ICU admission and an ICU + IMV admission were EUR 883, EUR 1,925 and EUR 3,183, respectively.
The authors noted that as the risk of admission to ICU and ICU + IMV increases alongside BMI, and because ICU admission and ICU admission including ventilator support are more expensive than a general hospital admission, the estimated average cost per hospital admission due to COVID‐19 also increases alongside BMI. The cost of an average admission varied among the four reference countries and was most expensive in Denmark.
They estimated that the total direct costs of secondary care during the first wave of COVID‐19 in Europe were EUR 13.9 billon, whereof 76% (EUR 10.5 billion) accounted for treating people with overweight and obesity. The average cost per hospital admission increased with BMI, from EUR 15,831 for BMI<25 kg/m2 to EUR 30,982 for BMI ≥40 kg/m2, so the average hospital costs of treating a person with BMI ≥40 kg/m2 are twice as high than the hospital costs of treating a person with BMI <25 kg/m2 due to increased risk of severe outcomes of COVID‐19 (EUR 30,982 vs EUR 15,831 = 1.96). The costs of severe COVID‐19 outcomes among people with obesity were estimated at EUR 6.1 billion, 44% of the total direct costs of secondary care.
“To our knowledge, this is the first study to estimate the total direct costs of secondary care of COVID‐19 associated with overweight and obesity in Europe…Our study reveals that overweight and obesity contribute disproportionally to the costs of COVID‐19. Both the economic costs and the number of people dying from COVID‐19 would be lower if overweight and obesity rates were lower across all European countries,” the authors concluded. “Overweight and obesity appears to have caused the COVID‐19 pandemic to hit both citizens and secondary care systems in Europe to a high extent.”
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