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Evaluation of Healthcare Utilization in Patients with Metabolic Syndrome

Abstract
Metabolic Syndrome is a cluster of cardio-metabolic risk factors, including obesity, hyperglycemia, dyslipidaemia and hypertension, and has been linked with elevated risk of developing Cardiovascular Disease and Type 2 Diabetes. It is estimated that approximately 39% of the US adult population meets the criteria for Metabolic Syndrome. The aim of this project was to evaluate the role of positive diagnosis of Metabolic Syndrome on Healthcare Utilization specifically on the annual number of hospitalizations and doctor office visits. Data on 16,632 subjects was extracted from the Third National Health and Nutrition Examination Survey dataset and used for analysis. It was concluded from Multivariate Multiple Regression model that the number of hospitalizations and doctor’s office visits is significantly higher in subjects with Metabolic Syndrome accounting for differences in age, race and gender. It was also seen that the variables selected for analysis accounted for a very small percentage of the variance in number of hospitalizations and doctor office visits. It was hence concluded that further work was required to evaluate the influence of Metabolic Syndrome on healthcare utilization while accounting for these unknown factors. 

Introduction
Metabolic Syndrome (MetS) is a cluster of cardio-metabolic risk factors that has shown to significantly increase the risk of developing Cardiovascular Disease (CVD) and Type 2 Diabetes Mellitus (T2DM). Risk factors include abdominal obesity, hyperglycemia (elevated blood glucose), dyslipidaemia (abnormal blood lipid levels) and hypertension (elevated blood pressure). It is estimated that 2500 Americans die from CVD each day with costs related to CVD approximating to $403 billion annually. Studies have shown that having MetS doubles the risk of developing CVD and increases the risk of developing T2DM by a factor of seven. A study in 2005 estimated that approximately 39% of the US adult population meets the criteria for Metabolic Syndrome. [3] The aim for this project was to compare Healthcare Utilization trends in patients with and without MetS. Healthcare utilization is defined as the level of usage of medical services and can be measured using variables such as Number of Hospitalizations, Number of Emergency Room Visits, Number of Doctors Office Visits, etc. Since MetS is associated with several co-morbidities, it is conceivable that it can lead to higher healthcare utilization.

Conclusion
Statistical analysis has led to the acceptance of both alternative hypotheses. A positive diagnosis of Metabolic Syndrome leads to higher number of Hospitalizations and doctor;s office visits. However, it was also evident that the variables used to create the model accounted for a very small percentage of the variance and that there exist unknown factors which influence healthcare utilization. A limitation of the study was that only two variables pertinent to Healthcare Utilization were readily available. Additional work is required to test the effect of Metabolic Syndrome with a more detailed definition of Healthcare Utilization. [5] The study of Healthcare Utilization is important in addition to traditional healthcare outcomes to appropriately gauge the effect of Metabolic Syndrome. This study, while not extensive in its exploration of Healthcare Utilization, lays the foundation for future work in this area.