Hospital Length of Stay, Charges and Costs Associated with a Diagnosis of Obesity in U.S. Children and Youth, 2006 – 2016

Obesity is associated with numerous serious health care costs and health consequences, including asthma, some cancers, type II diabetes mellitus, and mental health conditions. Researchers have previously quantified the economic burden of obesity-associated hospitalizations among children (Wang, 2002; Trasande, 2009). However, information covering the last decade of data on hospital care costs and utilization in children with obesity is lacking. Our paper uses the most recent data from the Healthcare Cost and Utilization Project (HCUP) to analyze trends in obesity-associated hospitalizations and to quantify the effects of childhood obesity on hospital costs, charges and length of stay.

We use the Nationwide Inpatient Sample (NIS) data from 2006 – 2016 to evaluate trends in obesity-associated hospitalizations and charges among U.S. children 2-19 years of age. Using the multinomial logistic model, we assess the relationship between demographic or hospital factors and obesity as a primary or secondary diagnosis. Further, we identify the most frequent diagnostic categories for which obesity is a secondary diagnosis, and evaluate whether obesity is increasing as a comorbidity for these diagnostic categories. Finally, our paper uses negative binomial and loglinear regression models to estimate the impact of diagnosed obesity on hospital length of stay, charges and costs in U.S. children and youth. All estimations are performed using a five percent significance level.

Our preliminary findings detect a 76 percent increase in the hospitalizations of U.S. children with a diagnosis of obesity from 2006 to 2016. We also find a rise in the obesity-associated hospital charges from $985.4 million to $2.6 billion (in 2016 dollars) between 2006 and 2016. We demonstrate that hospitalizations are characterized by significantly larger length of stay, charges and costs when obesity is present as a secondary diagnosis. When obesity is present as a primary diagnosis, we find that hospitalizations have a lower length of stay, but higher charges and costs, compared to hospitalizations with no diagnosis of obesity. The findings of this paper can be used by other researchers to analyze the economic effectiveness of interventions or to understand whether future investment in interventions is justified.

Sources

Wang, G., & Dietz, W. H. (2002). Economic burden of obesity in youths aged 6 to 17 years: 1979–1999. Pediatrics, 109(5), e81-e81.

Trasande, L., Liu, Y., Fryer, G., & Weitzman, M. (2009). Effects of childhood obesity on hospital care and costs, 1999–2005. Health Affairs, 28(4), w751-w760.