Hering Elie, Pritsker Irena, Gonchar Ludmila, Pillar Giora
Pediatrics Department, Clalit General Health Care, Child Care Center, Tirat Hacarmel, 34349 Israel.
Clin Pediatr (Phila). 2009 Oct;48(8):812-8. doi: 10.1177/0009922809336072. Epub 2009 Jun 1.
The prevalence of obesity in children has steadily risen during recent years in developed countries. There is increasing data associating this rise in obesity with a rise in morbidity. In adults, data show clear association between obesity and health care use. This study examined the effects of obesity on health care use in children of several age groups.
The population consisted of children from Tirat HaCarmel, Israel, who are patients at the town's Clalit Health Care, Child Care Center (CCC). All obese children (body mass index [BMI] > 95%) participated and were matched by age and gender with nonobese children (BMI < 85%) who served as a control group. Children were further divided into 3 age groups: ages 4 to 7 years, 8 to 11 years, and 12 to 18 years. Health care use was measured by 4 criteria over a 2-year time period: clinic visits, emergency department visits, hospitalizations, and medication use.
Of more than 4000 children treated in the CCC, 363 obese children were matched to 382 control children. Obese children had significantly more clinic visits (4942 vs 4058, P < .001), had more hospitalizations (67 vs 34, P < .001), were hospitalized for longer periods (207 vs 79 days, P < .001), and used significantly more medications (5945 vs 4638, P < .001) than did the control group.
This study provides objective clinical evidence that obesity in children is associated with increased health care use. This information has clear implications for both the public health and health insurance sectors and supports the need to invest in efforts to reduce childhood obesity.
近年来,发达国家儿童肥胖率持续上升。越来越多的数据表明,肥胖率的上升与发病率的增加有关。在成年人中,数据显示肥胖与医疗保健使用之间存在明显关联。本研究调查了肥胖对几个年龄组儿童医疗保健使用的影响。
研究对象为以色列提拉特哈卡梅尔镇克拉利特医疗保健儿童保育中心(CCC)的儿童。所有肥胖儿童(体重指数[BMI]>95%)均参与研究,并按年龄和性别与作为对照组的非肥胖儿童(BMI<85%)进行匹配。儿童进一步分为3个年龄组:4至7岁、8至11岁和12至18岁。在两年时间内,通过4项标准衡量医疗保健使用情况:门诊就诊、急诊就诊、住院治疗和药物使用。
在CCC接受治疗的4000多名儿童中,363名肥胖儿童与382名对照儿童进行了匹配。肥胖儿童的门诊就诊次数显著更多(4942次对4058次,P<0.001),住院次数更多(67次对34次,P<0.001),住院时间更长(207天对79天,P<0.001),并且使用的药物显著更多(5945次对4638次,P<0.001)。
本研究提供了客观的临床证据,表明儿童肥胖与医疗保健使用增加有关。这一信息对公共卫生和健康保险部门都有明确的影响,并支持投资于减少儿童肥胖的努力的必要性。