Buescher Paul A, Whitmire J Timothy, Plescia Marcus
State Center for Health Statistics, 1908 Mail Service Center, Raleigh, NC 27699-1908, USA.
Prev Chronic Dis. 2008 Jan;5(1):A04. Epub 2007 Dec 15.
Many studies document that overweight and obese adults have substantially higher medical care expenditures than do adults of normal weight, but comparable data for children or adolescents are few. This study examines patterns of expenditure for medical care and use of medical care services among a sample of North Carolina adolescents enrolled in Medicaid, stratified by body mass index categories.
North Carolina public health records, which include clinically measured height and weight, were linked to 2004 North Carolina Medicaid enrollment records to find adolescents aged 12-18 years whose records matched. We then examined all paid claims for 2004 of the 3528 adolescents whose records matched. Total expenditures by sex and race, hospital costs, physician costs, and prescription drug costs were tabulated and stratified by body mass index. We also examined, by body mass index, the percentage of adolescents who had a paid claim for selected diagnosed health conditions.
Overall, and for most demographic and service categories, overweight adolescents and at-risk-for-overweight adolescents had higher average Medicaid expenditures than did normal-weight adolescents. Some of these differences were statistically significant. Overweight adolescents were significantly more likely to have a paid claim for services related to diabetes, asthma, or other respiratory conditions.
Although based on a small sample, our results suggest that overweight has negative health consequences as early as adolescence. Further studies with larger samples could help confirm the findings of our study.
许多研究表明,超重和肥胖的成年人的医疗保健支出比正常体重的成年人要高得多,但针对儿童或青少年的类似数据却很少。本研究调查了北卡罗来纳州参加医疗补助计划的青少年样本中医疗保健支出模式及医疗保健服务的使用情况,并按体重指数类别进行了分层。
将包含临床测量身高和体重的北卡罗来纳州公共卫生记录与2004年北卡罗来纳州医疗补助计划登记记录相链接,以找出记录匹配的12至18岁青少年。然后,我们检查了记录匹配的3528名青少年在2004年的所有已支付索赔。按性别和种族、医院费用、医生费用和处方药费用列出总支出,并按体重指数进行分层。我们还按体重指数检查了对选定诊断健康状况有已支付索赔的青少年的百分比。
总体而言,在大多数人口统计学和服务类别中,超重青少年和有超重风险的青少年的医疗补助平均支出高于正常体重青少年。其中一些差异具有统计学意义。超重青少年更有可能对与糖尿病、哮喘或其他呼吸道疾病相关的服务提出已支付索赔。
尽管基于小样本,但我们的结果表明,超重早在青春期就会对健康产生负面影响。更大样本的进一步研究可能有助于证实我们的研究结果。