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Cost of Hospital Care for Obese Children Has Doubled

Cheryl Clark, for HealthLeaders Media, July 10, 2009

Americans, and specifically taxpayers, paid nearly double in costs of hospitalizing obese children between 1999 and 2005, with almost twice as many such children requiring hospital care, according to a new report in the journal Health Affairs.

The authors don't know exactly why, since the prevalence of childhood obesity did not change.

However, they speculate that physicians may be more frequently listing obesity as a primary or secondary reason for admission. Another possible reason is that children are becoming even more obese and for longer periods of time, giving disease processes much more time to cause damage.

Hospitalizations increased even for children as young as age 6.

The report evaluated hospitalizations whose primary or secondary diagnosis was listed as mental illness, pregnancy-related conditions, asthma, diabetes, appendicitis, pneumonia, skin and subcutaneous infections, biliary tract disease and other bone diseases in children and adolescents ages 2 to 19. All tolled, their care cost the healthcare system $237.6 million in 2005, up from $125.9 million in 2001, measured in 2005 dollars.

Seen in 2008 dollars, the numbers are 20% higher.

This is despite evidence from federal reports that the prevalence of obesity in children and adolescents did not go up in that period, the authors wrote.

"This is an unfortunate finding," said Leonardo Trasande, MD, assistant professor of community and preventive medicine at Mount Sinai School of Medicine in New York. Even if it's true that doctors are now more likely to list obesity as a contributing co-morbidity, "it means the cost burden is more reflective of reality, and people will need to refine their perspective of how much obesity is immediately contributing to children's health problems."

Obesity-related hospitalizations increased 8.8% per year among children 2 to 5, 10.4% per year among children 6 to 11 and 11.4% per year among adolescents 12-19 between 1999 and 2005.

Trasande and coauthors noted that it is likely the numbers are much worse, because there is evidence that physicians may not list obesity as a condition in the patient's chart. "If obesity prevalence among children with asthma is roughly equal to that for all American children, then one would expect about 20% of children hospitalized with asthma to be obese, yet we found less than 2% of asthma hospitalization with obesity listed as a co-morbidity."

The study used patient discharge statistics from the National Inpatient Sample, which reflects costs from government and private insurance payers at sampled hospitals across the U.S.

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