Effects Of Childhood Obesity On Hospital Care And Costs, 1999–2005

Trasande, Leonardo; Liu, Yinghua; Fryer, George E.; Weitzman, Michael

doi:10.1377/hlthaff.28.4.w751

Cited by 149 publications

(107 citation statements)

References 25 publications

(20 reference statements)

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“…Pediatric hospitalizations for obesity-related conditions have doubled in the last decade, mirroring the trend of higher levels of childhood obesity in the United States. [1][2][3] Recent studies have demonstrated worsened pediatric in-hospital outcomes, including mortality and increased resource utilization, for children with obesity across a range of diagnoses. [4][5][6][7][8][9][10] Although the mechanisms driving the association between obesity and in-hospital outcomes are not fully known, for asthma it is believed that adipocytes expressing inflammatory markers create a low level of systemic inflammation, thereby increasing the severity of allergic-type illnesses and decreasing the response to anti-inflammatory medications, such as steroids.…”

Section: Resultsmentioning

confidence: 99%

Childhood obesity and in-hospital asthma resource utilization

et al. 2014

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OBJECTIVE: To examine the relationship between pediatric obesity and inpatient length of stay (LOS), resource utilization, readmission rates, and total billed charges for inhospital status asthmaticus. DESIGN/METHODS:We conducted a cross-sectional study of patients 5 to 17 years old hospitalized with status asthmaticus to 1 free-standing children's hospital system over 12 months. Only hospitalized patients initially treated in the hospital's emergency department were included to ensure all therapies/charges were examined. Patients with complex chronic conditions, pneumonia, or lacking recorded body mass index (BMI) were excluded. The primary exposure was BMI percentile for age. The primary outcome was LOS (in hours). Secondary outcomes were 90-day readmission rate, billed charges, and resource utilization: number of albuterol treatments, chest radiographs, intravenous fluids, intravenous or intramuscular steroids, and intensive care unit admission. Bivariate, adjusted Poisson and logistic regression model analyses were performed. RESULTS:Five hundred eighteen patients met inclusion criteria. Most had a normal BMI (59.7%); 36.7% were overweight or obese. LOS, readmissions, and resource utilization outcomes were not associated with BMI category on bivariate analyses. After adjustment for demographic/ clinical characteristics, LOS decreased by 2% for each decile increase in BMI percentile for age. BMI percentile for age was not associated with billed charges, readmissions, or other measures of resource utilization.CONCLUSIONS: Although BMI decile for age is inversely associated with LOS for in-hospital pediatric status asthmaticus, the effect likely is not clinically meaningful. Pediatric hospitalizations for obesity-related conditions have doubled in the last decade, mirroring the trend of higher levels of childhood obesity in the United States. [1][2][3] Recent studies have demonstrated worsened pediatric in-hospital outcomes, including mortality and increased resource utilization, for children with obesity across a range of diagnoses. [4][5][6][7][8][9][10] Although the mechanisms driving the association between obesity and in-hospital outcomes are not fully known, for asthma it is believed that adipocytes expressing inflammatory markers create a low level of systemic inflammation, thereby increasing the severity of allergic-type illnesses and decreasing the response to anti-inflammatory medications, such as steroids. [11][12][13][14][15][16][17][18] The relationship of obesity and in-hospital asthma outcomes is of particular interest because status asthmaticus is the most common reason for admission in children aged 3 to 12 years, accounting for approximately 150,000 admissions (7.4% of all hospitalizations for children and adolescents) and $835 million in hospital costs annually. 19 Few prior studies have examined the association of obesity and asthma outcomes in the in-hospital setting. The studies examining this association have found patients with obesity to have a longer hospital length of stay (LOS) and i...

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Section: Resultsmentioning

confidence: 99%

Childhood obesity and in-hospital asthma resource utilization

et al. 2014

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“…The direct costs of childhood obesity include annual prescription drug, emergency room, and outpatient costs of $14.1 billion, 29 plus inpatient costs of $237.6 million. 30 An even larger cost is incurred when obese children become obese adults. About a third of obese preschool children, and about half of obese school-age children, become obese adults.…”

Section: Economic Consequences Of Childhood Obesitymentioning

confidence: 99%

The Economics Of Childhood Obesity

2010

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In the past few decades, obesity rates among American children have skyrocketed. Although many factors have played a part in this unhealthy increase, this paper focuses on how economic policies may be contributing to our children's growing girth and how these policies might be altered to reverse this trend. It examines the economic causes and consequences of obesity, the rationales for government intervention, the cost-effectiveness of various policies, and the need for more research funding.I n the twenty-five years that elapsed between surveys conducted in 1971-1974 and in 1999-2000, the prevalence of obesity rose from 5 percent to 10.4 percent among two-to-five-year-olds; from 4 percent to 15.3 percent among six-to-elevenyear-olds; and from 6.1 percent to 15.5 percent among twelve-to-nineteen-year-olds. 1,2 Economic Factors And Childhood ObesityChildhood obesity is a complex, multidisciplinary issue, so the search for solutions requires information sharing across many fields. To promote such exchange, this paper describes research findings from the field of economics. Relative to other disciplines, economics has only recently been applied to the study of obesity. As a result, there are many useful applications yet to be made.Economics offers several useful tools for the study of childhood obesity: insights into the economic causes and consequences of obesity, clearly defined rationales for government intervention in markets, and the use of cost-effectiveness analysis for comparing policies to prevent or reduce obesity. This paper summarizes recent research in each of those areas. It concludes by discussing the implications for health policy.Economic explanations for the recent rise in obesity tend to focus on changes that give people incentives to consume more or to burn fewer calories. These include the following.FOOD PRICES The real price of food (the price of food adjusted for inflation across all goods and services) has declined greatly in recent decades. For example, between 1990 and 2007 the real price of a two-liter bottle of Coca-Cola fell 34.89 percent, and that of a McDonald's quarter-pounder with cheese fell 5.44 percent.3 Some research indicates that reductions in the price of food account for 41-43 percent of the rise in young adults' body mass index (BMI) between 1981 and 1994. 4 BMI is most sensitive to the price of fast food in particular for youth from families of low socioeconomic status.5 The real price of fruit and vegetables rose 17 percent between 1997 and 2003, 6 an increase that some studies have linked to higher BMI in American children and adolescents. 7,8 AGRICULTURAL POLICIES The decline in the price of food could be due to agriculture policies. However, several studies have concluded that such policies have little impact on consumer prices of energy-dense foods.9,10 About half of farm subsidies are based on historic, not current, production, which limits incentives for farmers to increase output.9 Moreover, U.S. farm policy raises John Cawley (JHC38@cornell .ed...

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“…D.H.H.S., 2010), that significantly raise health care costs for youth (Trasande and Chatterjee, 2009;Trasande, Liu, Fryer et al, 2009). (Lee et al, 2007).…”

Section: Introductionmentioning

confidence: 99%

The impact of physical education on obesity among elementary school children

Cawley

Frisvold

Meyerhoefer

2013

Journal of Health Economics

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Standard-Nutzungsbedingungen:Die Dokumente auf EconStor dürfen zu eigenen wissenschaftlichen Zwecken und zum Privatgebrauch gespeichert und kopiert werden.Sie dürfen die Dokumente nicht für öffentliche oder kommerzielle Zwecke vervielfältigen, öffentlich ausstellen, öffentlich zugänglich machen, vertreiben oder anderweitig nutzen.Sofern die Verfasser die Dokumente unter Open-Content-Lizenzen (insbesondere CC-Lizenzen) zur Verfügung gestellt haben sollten, gelten abweichend von diesen Nutzungsbedingungen die in der dort genannten Lizenz gewährten Nutzungsrechte. www.econstor.eu The Institute for the Study of Labor (IZA) in Bonn is a local and virtual international research center and a place of communication between science, politics and business. IZA is an independent nonprofit organization supported by Deutsche Post Foundation. The center is associated with the University of Bonn and offers a stimulating research environment through its international network, workshops and conferences, data service, project support, research visits and doctoral program. IZA engages in (i) original and internationally competitive research in all fields of labor economics, (ii) development of policy concepts, and (iii) dissemination of research results and concepts to the interested public. Terms of use: Documents in D I S C U S S I O N P A P E R S E R I E SIZA Discussion Papers often represent preliminary work and are circulated to encourage discussion. Citation of such a paper should account for its provisional character. A revised version may be available directly from the author.IZA Discussion Paper No. 6807 August 2012 ABSTRACT The Impact of Physical Education on Obesity among Elementary School Children 1In response to the dramatic rise in childhood obesity, the Centers for Disease Control (CDC) and other organizations have advocated increasing the time that elementary school children spend in physical education (PE) classes. However, little is known about the effect of PE on child weight. This paper measures that effect by instrumenting for child PE time with state policies, using data from the Early Childhood Longitudinal Study, Kindergarten Cohort (ECLS-K) for 1998-2004. Results from IV models indicate that PE lowers BMI z-score and reduces the probability of obesity among 5 th graders (in particular, boys), while the instrument is insufficiently powerful to reliably estimate effects for younger children. This represents some of the first evidence of a causal effect of PE on youth obesity, and thus offers at least some support to the assumptions behind the CDC recommendations. We find no evidence that increased PE time crowds out time in academic courses or has spillovers to achievement test scores.JEL Classification: I12, I18, I21, H75, K32

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Effects Of Childhood Obesity On Hospital Care And Costs, 1999–2005

Cited by 149 publications

References 25 publications

Childhood obesity and in-hospital asthma resource utilization

Childhood obesity and in-hospital asthma resource utilization

The Economics Of Childhood Obesity

The impact of physical education on obesity among elementary school children

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