Relationship between Waist Circumference, Body Mass Index, and Medical Care Costs

Authors

  • Marc-Andre Cornier M.D.,

    Corresponding author
    1. Department of Medicine, Denver Health Medical Center and Division of Endocrinology, Metabolism, and Diabetes, Department of Medicine, University of Colorado Health Sciences Center, Denver, Colorado
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  • Charles W. Tate,

    1. Department of Medicine, Denver Health Medical Center and Division of Endocrinology, Metabolism, and Diabetes, Department of Medicine, University of Colorado Health Sciences Center, Denver, Colorado
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  • Gary K. Grunwald,

    1. Department of Medicine, Denver Health Medical Center and Division of Endocrinology, Metabolism, and Diabetes, Department of Medicine, University of Colorado Health Sciences Center, Denver, Colorado
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  • Daniel H. Bessesen

    1. Department of Medicine, Denver Health Medical Center and Division of Endocrinology, Metabolism, and Diabetes, Department of Medicine, University of Colorado Health Sciences Center, Denver, Colorado
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Denver Health Medical Center, 777 Bannock St., Mail Code 4000, Denver, CO 80204-4507. E-mail: mcornier@dhha.org

Abstract

Objective: Excessive visceral adiposity as measured by anthropomorphic measures may be more closely associated with adverse health consequences than body weight or body mass index (BMI), the more commonly obtained clinical measures. Waist circumference (WC) provides information about regional adiposity and may correlate with health care costs better than body weight or BMI.

Research Methods and Procedures: A total of 424 men (37%) and women (63%) were identified as they were seen in outpatient medical clinics at Denver Health, an integrated health care system serving a largely indigent population. Height, weight, and WC were measured by one examiner. Information on outpatient, laboratory, pharmacy, inpatient, and total charges attributable to each subject for the preceding year were obtained from computerized databases. Data on health care charges were divided into quartiles based on WC and BMI.

Results: Total annual health care charges were significantly greater in the highest WC quartile (WC < 83.3 cm: $6062 ± $784; 83.3 to 93.5 cm: $5968 ± $812; 93.7 to 103.5 cm: $6369 ± $1015; >103.5 cm: $8699 ± $1092; p = 0.047). Those with a WC >103.5 cm generated 85% more inpatient charges than the group with a WC <83.3 cm. Although there was a positive trend, BMI was not found to significantly correlate with total health care charges in this population sample.

Discussion: These results suggest that abdominal adiposity as assessed by WC is associated with increased total health care charges and may be a better predictor of health care charges than the more widely used BMI.

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