Obesity raises children's health costs

By Anthony J. Brown, MD

NEW YORK (Reuters Health) - Consistent with what is seen adults, overweight and obese children use the healthcare system more and incur higher health expenditures than their normal-weight peers, new research shows.

"Increased laboratory use was the main change in healthcare utilization seen in obese children," Dr. Sarah E. Hampl, from the University of Missouri-Kansas City School of Medicine, told Reuters Health.

She pointed out that this is not necessarily a bad thing. It could be interpreted as "a good thing, because once a child is diagnosed with obesity, we do want clinicians to be looking for complications of obesity." Still, the attendant costs represent a major burden on the healthcare system.

The findings, which appear in the Archives of Pediatrics and Adolescent Medicine, are based on a study of 8404 children, between 5 and 18 years of age, who were seen for a well-child visit in 2002 and 2003 and were followed for 12 months. Just over half of them were 10 years of age or older, nearly two-thirds were African American, and almost three-quarters were covered by Medicaid.

Based on standard classifications, 18 percent of the children were overweight and 22 percent were obese, the report indicates. It also shows that just 43 percent of obese children were actually diagnosed with obesity.

Hampl cited two main factors that likely contribute to the under-diagnosis of obesity: failure to assess and record the child's body mass index, or BMI, during office visits, and not recording "obesity" on billing forms out of fear of not being reimbursed.

Compared with healthy-weight children, those with diagnosed or undiagnosed obesity were more likely to have used laboratory services. Moreover, children with diagnosed obesity had average healthcare expenditures that exceeded those of healthy-weight children by $172.

However, Hampl said, this excess spending may be worth it, as preventing the complications of obesity during childhood is most certainly cheaper than addressing the complications once they occur in adulthood.

SOURCE: Archives of Pediatrics and Adolescent Medicine, January 2007.