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

Obesity (Silver Spring). 2007 Jul;15(7):1895-901. doi: 10.1038/oby.2007.224.


Objective: 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.

Methods: 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.

Results: 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).

Conclusion: 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.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Child
  • Child, Hospitalized / education
  • Child, Hospitalized / statistics & numerical data*
  • Child, Preschool
  • Cost of Illness
  • Humans
  • Inpatients
  • Length of Stay
  • Michigan / epidemiology
  • Obesity / epidemiology*