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Obesity (Silver Spring). 2007 Jul;15(7):1895-901.

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

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Research Unit, Gerald R. Ford School of Public Policy, University of Michigan, 300 NIB, Room 6D22, Campus Box 0456, Ann Arbor, MI 48109-0456, USA.



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.


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.


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).


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.

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