Increased medical costs in elders with the metabolic syndrome are most evident with hospitalization of men

Yu-Hung Chang, Rosalind Chia-Yu Chen, Meei-Shyuan Lee, Mark L. Wahlqvist

Research output: Contribution to journalArticleResearchpeer-review

3 Citations (Scopus)

Abstract

Background: Little is known about health care costs associated with the metabolic syndrome (MetS). Objective: We assessed annualized health care costs and health outcomes for both genders in different health care settings among representative Taiwanese elders. Methods: The Nutrition and Health Survey in Taiwan (1999-2000) provided 1378 individuals aged 65 years or older with known MetS status. Nutrition and Health Survey in Taiwan files were linked to National Health Insurance records (1999-2006). Student t tests and multiple regression models were used to assess expenditures in total and in 6 services: inpatient, ambulatory care, dental care, traditional Chinese medicine, emergency care, and contracted pharmacy. The Cox model was used to assess gender effect on all-cause mortality and cardiovascular disease mortality, whereas logistic regression was used for that on cardiovascular disease hospitalization. The 5 MetS component costs were evaluated by multiple regressions. Results: MetS affected 29% of men and 48% of women. After full adjustment, those with MetS had 1.30 (95% CI, 1.11-1.52), men had 1.43 (95% CI, 1.20-1.70), and women had 1.19 (95% CI, 0.93-1.52) times higher costs than those without MetS. Compared with no MetS, MetS costs were increased 2.94-fold for inpatient care (95% CI, 1.23-7.10) and 1.30-fold for ambulatory care for men (95% CI, 1.12-1.52), whereas ambulatory MetS costs were increased 1.28-fold for women (95% CI, 1.05-1.57). MetS was associated with higher risk of cardiovascular disease hospitalization in men (adjusted odds ratio, 1.76; 95% CI, 1.20-2.58) but not in women (adjusted odds ratio, 1.08; 95% CI, 0.67-1.75). Among those with MetS, all-cause and cardiovascular mortality were comparable between men and women. Of the MetS components, low HDL cholesterol had the greatest affect on costs, more so in men (2.23-fold) than women (1.58-fold). Conclusions: In people with MetS, service costs were greater overall, significantly for men, but not women, and these increased costs were evident for men who experienced hospitalization, but not women. At the same time, cardiovascular and all-cause mortalities were not significantly different by gender in regard to MetS in Taiwanese elders.

Original languageEnglish
Pages (from-to)348-360
Number of pages13
JournalGender Medicine
Volume9
Issue number5
DOIs
Publication statusPublished - Oct 2012

Keywords

  • ethics
  • gender
  • HDL cholesterol
  • health care costs
  • metabolic syndrome

Cite this

Chang, Yu-Hung ; Chen, Rosalind Chia-Yu ; Lee, Meei-Shyuan ; Wahlqvist, Mark L. / Increased medical costs in elders with the metabolic syndrome are most evident with hospitalization of men. In: Gender Medicine. 2012 ; Vol. 9, No. 5. pp. 348-360.
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title = "Increased medical costs in elders with the metabolic syndrome are most evident with hospitalization of men",
abstract = "Background: Little is known about health care costs associated with the metabolic syndrome (MetS). Objective: We assessed annualized health care costs and health outcomes for both genders in different health care settings among representative Taiwanese elders. Methods: The Nutrition and Health Survey in Taiwan (1999-2000) provided 1378 individuals aged 65 years or older with known MetS status. Nutrition and Health Survey in Taiwan files were linked to National Health Insurance records (1999-2006). Student t tests and multiple regression models were used to assess expenditures in total and in 6 services: inpatient, ambulatory care, dental care, traditional Chinese medicine, emergency care, and contracted pharmacy. The Cox model was used to assess gender effect on all-cause mortality and cardiovascular disease mortality, whereas logistic regression was used for that on cardiovascular disease hospitalization. The 5 MetS component costs were evaluated by multiple regressions. Results: MetS affected 29{\%} of men and 48{\%} of women. After full adjustment, those with MetS had 1.30 (95{\%} CI, 1.11-1.52), men had 1.43 (95{\%} CI, 1.20-1.70), and women had 1.19 (95{\%} CI, 0.93-1.52) times higher costs than those without MetS. Compared with no MetS, MetS costs were increased 2.94-fold for inpatient care (95{\%} CI, 1.23-7.10) and 1.30-fold for ambulatory care for men (95{\%} CI, 1.12-1.52), whereas ambulatory MetS costs were increased 1.28-fold for women (95{\%} CI, 1.05-1.57). MetS was associated with higher risk of cardiovascular disease hospitalization in men (adjusted odds ratio, 1.76; 95{\%} CI, 1.20-2.58) but not in women (adjusted odds ratio, 1.08; 95{\%} CI, 0.67-1.75). Among those with MetS, all-cause and cardiovascular mortality were comparable between men and women. Of the MetS components, low HDL cholesterol had the greatest affect on costs, more so in men (2.23-fold) than women (1.58-fold). Conclusions: In people with MetS, service costs were greater overall, significantly for men, but not women, and these increased costs were evident for men who experienced hospitalization, but not women. At the same time, cardiovascular and all-cause mortalities were not significantly different by gender in regard to MetS in Taiwanese elders.",
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author = "Yu-Hung Chang and Chen, {Rosalind Chia-Yu} and Meei-Shyuan Lee and Wahlqvist, {Mark L.}",
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Increased medical costs in elders with the metabolic syndrome are most evident with hospitalization of men. / Chang, Yu-Hung; Chen, Rosalind Chia-Yu; Lee, Meei-Shyuan; Wahlqvist, Mark L.

In: Gender Medicine, Vol. 9, No. 5, 10.2012, p. 348-360.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Increased medical costs in elders with the metabolic syndrome are most evident with hospitalization of men

AU - Chang, Yu-Hung

AU - Chen, Rosalind Chia-Yu

AU - Lee, Meei-Shyuan

AU - Wahlqvist, Mark L.

PY - 2012/10

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N2 - Background: Little is known about health care costs associated with the metabolic syndrome (MetS). Objective: We assessed annualized health care costs and health outcomes for both genders in different health care settings among representative Taiwanese elders. Methods: The Nutrition and Health Survey in Taiwan (1999-2000) provided 1378 individuals aged 65 years or older with known MetS status. Nutrition and Health Survey in Taiwan files were linked to National Health Insurance records (1999-2006). Student t tests and multiple regression models were used to assess expenditures in total and in 6 services: inpatient, ambulatory care, dental care, traditional Chinese medicine, emergency care, and contracted pharmacy. The Cox model was used to assess gender effect on all-cause mortality and cardiovascular disease mortality, whereas logistic regression was used for that on cardiovascular disease hospitalization. The 5 MetS component costs were evaluated by multiple regressions. Results: MetS affected 29% of men and 48% of women. After full adjustment, those with MetS had 1.30 (95% CI, 1.11-1.52), men had 1.43 (95% CI, 1.20-1.70), and women had 1.19 (95% CI, 0.93-1.52) times higher costs than those without MetS. Compared with no MetS, MetS costs were increased 2.94-fold for inpatient care (95% CI, 1.23-7.10) and 1.30-fold for ambulatory care for men (95% CI, 1.12-1.52), whereas ambulatory MetS costs were increased 1.28-fold for women (95% CI, 1.05-1.57). MetS was associated with higher risk of cardiovascular disease hospitalization in men (adjusted odds ratio, 1.76; 95% CI, 1.20-2.58) but not in women (adjusted odds ratio, 1.08; 95% CI, 0.67-1.75). Among those with MetS, all-cause and cardiovascular mortality were comparable between men and women. Of the MetS components, low HDL cholesterol had the greatest affect on costs, more so in men (2.23-fold) than women (1.58-fold). Conclusions: In people with MetS, service costs were greater overall, significantly for men, but not women, and these increased costs were evident for men who experienced hospitalization, but not women. At the same time, cardiovascular and all-cause mortalities were not significantly different by gender in regard to MetS in Taiwanese elders.

AB - Background: Little is known about health care costs associated with the metabolic syndrome (MetS). Objective: We assessed annualized health care costs and health outcomes for both genders in different health care settings among representative Taiwanese elders. Methods: The Nutrition and Health Survey in Taiwan (1999-2000) provided 1378 individuals aged 65 years or older with known MetS status. Nutrition and Health Survey in Taiwan files were linked to National Health Insurance records (1999-2006). Student t tests and multiple regression models were used to assess expenditures in total and in 6 services: inpatient, ambulatory care, dental care, traditional Chinese medicine, emergency care, and contracted pharmacy. The Cox model was used to assess gender effect on all-cause mortality and cardiovascular disease mortality, whereas logistic regression was used for that on cardiovascular disease hospitalization. The 5 MetS component costs were evaluated by multiple regressions. Results: MetS affected 29% of men and 48% of women. After full adjustment, those with MetS had 1.30 (95% CI, 1.11-1.52), men had 1.43 (95% CI, 1.20-1.70), and women had 1.19 (95% CI, 0.93-1.52) times higher costs than those without MetS. Compared with no MetS, MetS costs were increased 2.94-fold for inpatient care (95% CI, 1.23-7.10) and 1.30-fold for ambulatory care for men (95% CI, 1.12-1.52), whereas ambulatory MetS costs were increased 1.28-fold for women (95% CI, 1.05-1.57). MetS was associated with higher risk of cardiovascular disease hospitalization in men (adjusted odds ratio, 1.76; 95% CI, 1.20-2.58) but not in women (adjusted odds ratio, 1.08; 95% CI, 0.67-1.75). Among those with MetS, all-cause and cardiovascular mortality were comparable between men and women. Of the MetS components, low HDL cholesterol had the greatest affect on costs, more so in men (2.23-fold) than women (1.58-fold). Conclusions: In people with MetS, service costs were greater overall, significantly for men, but not women, and these increased costs were evident for men who experienced hospitalization, but not women. At the same time, cardiovascular and all-cause mortalities were not significantly different by gender in regard to MetS in Taiwanese elders.

KW - ethics

KW - gender

KW - HDL cholesterol

KW - health care costs

KW - metabolic syndrome

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DO - 10.1016/j.genm.2012.08.005

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VL - 9

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JO - Gender Medicine

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SN - 1550-8579

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