OBJECTIVES:

To examine the association between annualized health services utilization as well as direct healthcare costs, and excess body weight (overweight: body mass index, BMI ≥25.00 and < 30.00 kg/m², and obesity as BMI ≥30.00 kg/m²) among older adults in Ghana.

METHODS:

We used a nationally representative sample of 2921 adults aged ≥50 years with BMI ≥18.50kg/m² from the Ghana WHO Study on Global AGEing and Adult Health (Wave 2, 2014/15) to examine the annual health service utilization and direct healthcare costs (2017 US dollars) by outpatient and inpatient services. Costs included those incurred by the National Health Insurance Scheme (NHIS) and patient out-of-pocket costs. Survey multivariable zero-inflated binomial and two-part regression models were employed to determine associations between the outcome measures and overweight/obesity.

RESULTS:

Twenty-six percent of the sample were overweight and 15% were obese. In comparison to normal weight participants, multivariable analysis revealed that i) overweight was associated with 54% higher utilisation of inpatient services, and ii) obesity was associated with 83% increased utilisation of inpatient services and 43% increase for outpatient services. These utilization rates translated into costs of which the NHIS bore approximately 61% of the outpatient and 53% of the inpatient services costs per person in 2014/15. Multivariable analysis showed that the mean annualized costs associated with having normal weight were USD48.69 for outpatient services and USD136.0 for inpatient services. Overweight led to costs of USD80.77 for outpatient services and USD245.43 for inpatient services. Obesity led to costs of USD108.57 for outpatient services, and USD336.33 for inpatient services. The costs for overweight and obesity groups were all statistically significantly different from normal weight.

CONCLUSIONS:

Excess body weight was associated with higher annual health service utilization and direct healthcare costs in the older adult population of Ghana.