Economic and Clinical Burden of MACE-Related Rehospitalizations in Patients With Obesity: A Real-World Study Based on Italian Healthcare Data
Author(s)
Paolo Sciattella, MSc, PhD, Matteo Scortichini, MSc.
Economic Evaluation and HTA (EEHTA CEIS), University of Rome "Tor Vergata", Rome, Italy.
Economic Evaluation and HTA (EEHTA CEIS), University of Rome "Tor Vergata", Rome, Italy.
OBJECTIVES: Major Adverse Cardiovascular Events (MACE) encompass serious outcomes, including non-fatal myocardial infarction, stroke, and cardiovascular death. The incidence of MACE is notably higher in individuals with obesity, as excess adipose tissue contributes to metabolic and inflammatory alterations that increase cardiovascular risk. This study aimed to estimate the economic burden of MACE-related rehospitalizations in patients with a history of cardiovascular events in Italy, and to evaluate whether this impact varies based on obesity status.
METHODS: All Italian residents who experienced at least one acute hospitalization for MACE between 2015 and 2019 were identified. Patients with a prior diagnosis of diabetes, as well as those who died during the index hospitalization or within two years thereafter, were excluded. Each patient was followed for two years to estimate the rehospitalization rate for MACE and the related costs to the Italian National Health Service. Results were stratified by obesity class, determined through prior hospital admissions reporting ICD-9-CM codes for overweight, unspecified, or severe obesity.
RESULTS: A total of 1,292,232 patients with a primary hospitalization for MACE were included in the final cohort after applying exclusion criteria. Over the two-year follow-up period, 29.6% of patients without a diagnosis of obesity were rehospitalized, with a mean of 1.45 hospitalizations per patient and associated costs of €2,413 per patient. For patients classified as overweight, the re-hospitalization rate increased to 31.6%, resulting in average costs of €2,508 per patient. Among those with unspecified obesity, the rehospitalization rate rose to 38.7%, with costs reaching €3,488 per patient. Patients with severe obesity had the highest rehospitalization rate at 39.2%, averaging 1.60 hospitalizations per patient and incurring average costs of €3,638.
CONCLUSIONS: Obesity is associated with a higher risk of MACE-related rehospitalizations and increased healthcare costs. These findings emphasize the need for targeted interventions to reduce the burden on this high-risk population.
METHODS: All Italian residents who experienced at least one acute hospitalization for MACE between 2015 and 2019 were identified. Patients with a prior diagnosis of diabetes, as well as those who died during the index hospitalization or within two years thereafter, were excluded. Each patient was followed for two years to estimate the rehospitalization rate for MACE and the related costs to the Italian National Health Service. Results were stratified by obesity class, determined through prior hospital admissions reporting ICD-9-CM codes for overweight, unspecified, or severe obesity.
RESULTS: A total of 1,292,232 patients with a primary hospitalization for MACE were included in the final cohort after applying exclusion criteria. Over the two-year follow-up period, 29.6% of patients without a diagnosis of obesity were rehospitalized, with a mean of 1.45 hospitalizations per patient and associated costs of €2,413 per patient. For patients classified as overweight, the re-hospitalization rate increased to 31.6%, resulting in average costs of €2,508 per patient. Among those with unspecified obesity, the rehospitalization rate rose to 38.7%, with costs reaching €3,488 per patient. Patients with severe obesity had the highest rehospitalization rate at 39.2%, averaging 1.60 hospitalizations per patient and incurring average costs of €3,638.
CONCLUSIONS: Obesity is associated with a higher risk of MACE-related rehospitalizations and increased healthcare costs. These findings emphasize the need for targeted interventions to reduce the burden on this high-risk population.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
RWD68
Topic
Epidemiology & Public Health, Health Technology Assessment, Real World Data & Information Systems
Topic Subcategory
Health & Insurance Records Systems
Disease
Cardiovascular Disorders (including MI, Stroke, Circulatory), Diabetes/Endocrine/Metabolic Disorders (including obesity)