Incremental hospital charges associated with obesity as a secondary diagnosis in children

Susan J. Woolford*, Achamyeleh Gebremariam, Sarah J. Clark, Matthew M. Davis

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

68 Scopus citations

Abstract

Objective: The objective was to evaluate the association of obesity as a comorbidity with hospital charges, by comparing charges for pediatric hospitalizations with vs. without obesity as a secondary diagnosis. Methods: Using the 2000 Healthcare Cost and Utilization Project (HCUP) Kids' Inpatient Database (KID), a nationally representative sample of pediatric hospital discharges, we identified the most common non-pregnancy-related principal diagnoses for children 2 to 18 years of age: asthma, pneumonia, affective disorders, and appendicitis. For each we compared mean charges and mean length of stay for hospitalizations with vs. without obesity as a secondary diagnosis, adjusting for relevant socio-demographics and hospital type. Results: Among children's discharges in 2000, 1.1% listed obesity as a secondary diagnosis. These had a disproportionate likelihood of being older, black, Medicaid beneficiaries, and hospitalized at a general hospital. Adjusted mean hospital charges were significantly higher for discharges with obesity as a secondary diagnosis vs. those without: appendicitis ($14,134 vs. $11,049; p < 0.01), asthma ($7766 vs. $6043; p < 0.05), pneumonia ($12,228 vs. $9688; p < 0.05), and affective disorders ($8292 vs. $7769; p < 0.01). Whereas obesity as a secondary diagnosis was associated with a pattern of increased adjusted mean length of stay, only asthma and affective disorders had statistically significant differences (0.6 days) (p < 0.01). Conclusion: This national analysis suggests obesity as a secondary diagnosis is associated with significantly higher charges for the most common reasons for pediatric hospitalizations. This presents a financial imperative for further research to evaluate factors that contribute to higher inpatient charges related to obesity as a comorbidity and underscores the need for obesity prevention initiatives.

Original languageEnglish (US)
Pages (from-to)1895-1901
Number of pages7
JournalObesity
Volume15
Issue number7
DOIs
StatePublished - Jul 2007

Keywords

  • Comorbidity
  • Economics
  • Hospitalization
  • Pediatrics
  • Secondary diagnosis

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology
  • Nutrition and Dietetics

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