Cost of Hospital Care for Obese Children Has Doubled

There is caution in the report, the authors wrote. "Diagnosis is a product of clinical judgment and reimbursement by hospital payers and is subject to inaccuracy," they said.

Also, the Center for Medicare and Medicaid Services "officially recognized obesity as an illness in late 2004, and a diagnosis of obesity does not routinely result in additional reimbursement or risk adjustment. Obesity is unlikely to be included to justify an adverse outcome that might have occurred, because coding is unlikely to protect from litigation or otherwise exaggerate the impact of obesity on lengths-of-stay charges or costs."

Obesity likely influenced the reason for admission in a variety of ways. For example, obesity during pregnancy is a risk factor for perinatal complications and sleep apnea, and obesity also can affect skin function. Obesity is associated with postoperative complications for appendicitis and children who are obese may be likely to suffer mental disorders.

Medicaid bears a large share of the cost of hospitalizations in children with a secondary diagnosis of obesity with a cost of about $118 million in 2005, up from $53.6 million in 2001. "Increasing obesity among children appears to be driving increases in Medicaid spending," the authors wrote.

"Given the increasing burden of obesity-associated hospitalizations, our findings suggest that additional federal support of prevention programs could reduce obesity treatment costs borne by federal and state governments."

John Baker, MD, president of the American Society for Metabolic and Bariatric Surgery, said the study points to the need for more aggressive interventions, because clearly the higher costs associated with these hospitalizations justify spending more money to prevent them.

"We need to start with our children and adolescents as well as our young adults to treat obesity at all levels," says Baker, who practices in Little Rock, Ar. And there needs to be a core benefit added to our national health reform agenda."