Mendelian Randomization analysis of the causal effect of adiposity on hospital costs.
BMI
Healthcare costs
Instrumental variables
Mendelian Randomization
Obesity
Journal
Journal of health economics
ISSN: 1879-1646
Titre abrégé: J Health Econ
Pays: Netherlands
ID NLM: 8410622
Informations de publication
Date de publication:
03 2020
03 2020
Historique:
received:
25
04
2019
revised:
06
01
2020
accepted:
14
01
2020
pubmed:
6
2
2020
medline:
28
7
2021
entrez:
5
2
2020
Statut:
ppublish
Résumé
Estimates of the marginal effect of measures of adiposity such as body mass index (BMI) on healthcare costs are important for the formulation and evaluation of policies targeting adverse weight profiles. Most estimates of this association are affected by endogeneity bias. We use a novel identification strategy exploiting Mendelian Randomization - random germline genetic variation modelled using instrumental variables - to identify the causal effect of BMI on inpatient hospital costs. Using data on over 300,000 individuals, the effect size per person per marginal unit of BMI per year varied according to specification, including £21.22 (95% confidence interval (CI): £14.35-£28.07) for conventional inverse variance weighted models to £18.85 (95% CI: £9.05-£28.65) for penalized weighted median models. Effect sizes from Mendelian Randomization models were larger in most cases than non-instrumental variable multivariable adjusted estimates (£13.47, 95% CI: £12.51-£14.43). There was little evidence of non-linearity. Within-family estimates, intended to address dynastic biases, were imprecise.
Identifiants
pubmed: 32014825
pii: S0167-6296(19)30408-4
doi: 10.1016/j.jhealeco.2020.102300
pmc: PMC7188219
pii:
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Pagination
102300Subventions
Organisme : Medical Research Council
ID : MR/P014259/1
Pays : United Kingdom
Organisme : Medical Research Council
ID : MC_UU_12013/9
Pays : United Kingdom
Organisme : Medical Research Council
ID : MC_UU_12013/1
Pays : United Kingdom
Informations de copyright
Copyright © 2020 The Authors. Published by Elsevier B.V. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of Competing Interest The authors declare no conflicts of interest.
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