Length of Hospital Stays Among Obese Individuals

Zizza, Claire A.; Herring, Amy H.; Stevens, June; Popkin, Barry M.

doi:10.2105/ajph.94.9.1587

Cited by 97 publications

(88 citation statements)

References 34 publications

(38 reference statements)

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“…Past research, also using NHEFS data, found that obese persons spent more days in the hospital than their counterparts with healthy BMI levels (Zizza et al 2004). We also discovered increased utilization among individuals obese at baseline when examining separately the total number of hospitalization episodes (stays per year) and average length of stay.…”

Section: Discussionmentioning

confidence: 99%

“…The effects of obesity on hospitalization may be underestimated by studies of such short duration. Finally, some studies have controlled for morbidity, identifying health problems as an important intervening factor between obesity and health-care utilization (Bertakis and Azari 2005), while other studies have not controlled for morbidity, arguing that such statistical controls constitute overadjustment (Quesenberry et al 1998;Zizza et al 2004). Zizza and colleagues (2004) used an age-representative, nonclinical sample and address the question of obesity and prospective hospital usage.…”

Section: Prior Research On Obesity and Hospitalizationmentioning

confidence: 99%

“…In addition to exploring this new conceptual dimension, we also build upon past research and conceptualize hospital stays in a life-course framework (Ferraro et al 2006). Although most past research on obesity and length of hospitalization has either examined only a single hospital stay (Ray et al 2005) or aggregated data from multiple stays (Zizza et al 2004), the present study investigates both aggregate stay data and episodic data for individual stays. In this way, we seek to frame hospitalization as a strand of related experiences that are embedded in the individual's life course.…”

Section: Prior Research On Obesity and Hospitalizationmentioning

confidence: 99%

See 2 more Smart Citations

Obesity and Hospitalization over the Adult Life Course: Does Duration of Exposure Increase Use?

Schafer¹,

Ferraro

2007

J Health Soc Behav

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Consistent with a new genre of research on life-course analyses of health-service use, this study explores the consequences of long-term exposure to a risk factor. Drawing from cumulativedisadvantage theory, the study examines whether obesity, especially chronic obesity, increases hospitalization admission and length of stay. Analyses make use of hospital records abstracted over 20 years from a national survey of adults 41 to 77 years of age at baseline (n = 4,574). Multiple measures of body weight are used to calculate adult obesity duration. Results reveal that obesity increased hospital admissions and length of stay over the 20 years studied. Among persons obese at any time during the study, years of obesity also led to longer stays. The findings highlight the utility of measures of the duration of risk exposure for both life-course studies of health and tests of cumulative-disadvantage theory.The prevalence of obesity in America has risen substantially in the past two decades, even though scores of studies during this time have illuminated the health risks of excess body weight (Kopelman 2000;Ogden et al. 2006). Given the rise in obesity prevalence and the costs associated with acute-care hospitalization, the relationship between obesity and hospitalization is a matter of substantial policy interest.The health problems linked to excess adiposity make medical treatment more complicated, and obesity can therefore be expected to yield more and longer hospital stays (Quesenberry, Caan, and Jacobson 1998). Perhaps less well-recognized, however, is the potential impact of lifelong obesity on health-care use in middle and later life. Overweight and obesity in early adulthood combines with the difficulty of sustained weight loss after becoming obese to portend a major demographic scenario of chronic obesity. How will years of living as an obese person influence the use of health-care services?Research findings to date on obesity and hospitalization are inconsistent. Some studies show that obesity increases hospital-resource consumption (e.g., Raebel et al. 2004), while others show no difference in hospital use between obese and nonobese persons (e.g., Bertakis and Azari 2005). The present research draws from cumulative-disadvantage theory to address these discrepancies and to examine how the timing and duration of obesity shape the course of an individual's hospitalization experience. Knowing that a person's body mass index (BMI) exceeds 30 may be a useful piece of information in predicting hospitalization, but is the duration

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Section: Discussionmentioning

confidence: 99%

Section: Prior Research On Obesity and Hospitalizationmentioning

confidence: 99%

Section: Prior Research On Obesity and Hospitalizationmentioning

confidence: 99%

See 1 more Smart Citation

Obesity and Hospitalization over the Adult Life Course: Does Duration of Exposure Increase Use?

Schafer¹,

Ferraro

2007

J Health Soc Behav

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“…Based on the findings of various large-scale studies with various indications [15,34,47], it is plausible to presume that obese patients undergoing THA would have longer hospital stays and higher hospital costs through increased prevalence of chronic comorbidities and complications and longer recovery. For example, a large-scale study [15] included 35,000 orthopaedic surgeries and the length of stay was 1.1 days longer for morbidly obese patients, but it has been difficult to show this association in previous THA studies [4,10,14,19,21,33].…”

Section: Discussionmentioning

confidence: 99%

Obesity Increases Length of Stay and Direct Medical Costs in Total Hip Arthroplasty

Kremers

Visscher

Kremers

et al. 2014

Clinical Orthopaedics &Amp; Related Research

114

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Background The number of obese patients undergoing THA is increasing. Previous studies have shown that obesity is associated with an increased likelihood of complications after THA, but there is little information regarding the impact of obesity on medical resource use and direct medical costs in THA. Questions/purposes We sought to examine the relationship between obesity, length of stay, and direct medical costs in a large cohort of patients undergoing THAs. Methods The study included 8973 patients who had undergone 6410 primary and 2563 revision THAs at a large US medical center between January 1, 2000, and September 31, 2008. Patients with bilateral procedures within 90 days after index admission and patients with acute trauma were excluded. Data regarding clinical, surgical characteristics, and complications were obtained from the original medical records and the institutional joint registry. Patients were classified into eight groups based on their BMI at the time of surgery. Direct medical costs were calculated by using standardized, inflation-adjusted costs for services and procedures billed during hospitalization and the 90-day window. Study end points were hospital length of stay, direct medical costs during hospitalization, and the 90-day window. End points were compared across the eight BMI categories in multivariable risk-adjusted linear regression models. Results Mean length of stay and the direct medical costs were lowest for patients with a BMI of 25 to 35 kg/m 2 . Increasing BMI was associated with longer hospital stays and costs. Every five-unit increase in BMI beyond 30 kg/ m 2 was associated with approximately USD $500 higher hospital costs and USD $900 higher 90-day costs in primary THA (p = 0.0001), which corresponded to 5% higher costs. The cost increase associated with BMI was

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“…The steady rise in life expectancy in the USA during the past two centuries may be unfavourably influenced, by the increasing of obesity in the USA and its effect on longevity (Olshansky et al, 2005), although estimates of the excess morbidity and mortality associated to overweight remain imprecise (Flegal et al, 2004b(Flegal et al, , 2005Mark, 2005;McGee, 2005). From an economic point of view, health care costs (Raebel et al, 2004) and length of hospital stay (Zizza et al, 2004) for obese individuals are higher than for nonobese persons. In 1999 the expense in the USA on prescription medication to treat obesity was $321 million (Yanovski and Yanovski, 2002).…”

Section: Introductionmentioning

confidence: 99%

Overweight and obesity in Italian adults 2004, and an overview of trends since 1983

Gallus

Colombo²,

Scarpino³

et al. 2006

Eur J Clin Nutr

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Objective: Overweight has been increasing in several developed countries over the last few decades. No update information on the issue is available for Italy. Design and setting: We conducted a computer assisted personal in-house interview survey in March-April 2004, on a sample of 2932 Italian individuals (1407 men and 1525 women) aged 18 years or over, representative of the general adult Italian population. Information on weight and height was self-reported. Results: Overall, 3.4% of the Italian adult population were underweight (o18.5 kg/m 2 , 0.9% of men and 5.8% of women), 31.3% were overweight (25.0-29.9 kg/m 2 , 38.4% of men, 24.7% of women), and 8.2% were obese (X30.0 kg/m 2 , 7.4% of men and 8.9% of women). Overweight or obesity was reported by 14.2% of subjects aged 18-24 years (20.6% of men and 7.6% of women). The highest proportions of overweight and obese subjects were in the 45-64 year age group for men (51.4% overweight, 10.0% obese) and in the X65 year age group for women (38.8% overweight, 13.8% obese). Age-and sex-standardised prevalence of overweight or obesity was 36.0% for more educated subjects, and 54.0% for less educated ones. It was 32.3% in northern, 44.3% in central and 47.0% in southern Italy. Overweight increased from 1983 to the early 1990s, and levelled off thereafter. Prevalence of obesity remained around 8-9% across the last 20 years. Conclusions: Trends of overweight and obesity in Italy are more favourable than in several developed countries. Still, approximately 15 million of Italian adults are overweight and 4 million obese.

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Length of Hospital Stays Among Obese Individuals

Cited by 97 publications

References 34 publications

Obesity and Hospitalization over the Adult Life Course: Does Duration of Exposure Increase Use?

Obesity and Hospitalization over the Adult Life Course: Does Duration of Exposure Increase Use?

Obesity Increases Length of Stay and Direct Medical Costs in Total Hip Arthroplasty

Overweight and obesity in Italian adults 2004, and an overview of trends since 1983

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