S-Space College of Medicine/School of Medicine (의과대학/대학원) Dept. of Medicine (의학과) Theses (Master's Degree_의학과)
Impact of obesity on total hospital costs in patients who underwent colorectal cancer surgery
대장암으로 수술 받은 환자에서 비만이 진료비에 미치는 영향
- 의과대학 의학과
- Issue Date
- 서울대학교 대학원
- 학위논문 (석사)-- 서울대학교 대학원 : 의과대학 의학과, 2018. 2. 박규주.
- Introduction: The prevalence of obesity is increasing at a rapid rate. Obesity is associated with greater use of healthcare resources and obese patients have higher costs compared with other standardized body mass groups. Obesity is well-known cause of many systemic diseases and related to the development of colorectal cancer. However, only few studies examined the impact of obesity in colorectal cancer patients. This study aimed to determine whether obesity increases hospital costs in patients who underwent colorectal cancer surgery.
Methods: We retrospectively collected hospital billings for patients who underwent surgery for stage I-III colorectal cancer and analyzed the association between obesity and hospital cost. Obesity was assessed by preoperative body mass index (BMI) and computed tomography-assessed adipose tissue area. Primary outcome was hospital costs assessed by direct hospital billing during hospitalization.
Results: A total of 656 patients were analyzed in the study. Mean BMI was 23.92 ± 2.912 kg/m2, mean total adipose tissue (TAT) area was 249.57 ± 92.82 cm2 and mean visceral adipose tissue (VAT) area was 101.50 ± 56.57 cm2. The mean cost during index admission was 6,442,162.52 ± 2,480,435.78 ￦. We defined obese as the value over the cutoff value. In multivariate analysis by each obesity indices, obese patients defined by TAT area was significantly associated with higher total medical cost (p=0.046) and in multivariate analysis for subdivided medical cost according to TAT area, the higher operation/consultation cost significantly associated with obesity (p=0.003).
Conclusions: Increased total adipose tissue area but not BMI was associated with higher medical costs (p=0.046) in colorectal cancer patients, especially associated with the higher operation/consultation cost (p=0.003).