Division of General Pediatrics, Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX 75390-9063, USA.
Acad Pediatr. 2013 May-Jun;13(3):251-8. doi: 10.1016/j.acap.2013.02.005. Epub 2013 Feb 14.
To examine the association of overweight/obesity with health, health care utilization, and expenditures in a national sample of 10- to 17-year-old children and adolescents.
Secondary analysis of 2005 to 2009 Medical Expenditure Panel Survey data (n = 17,224). Outcome measures included suboptimal health, emotional/behavioral problems, health care utilization, and expenditures.
Overweight and obese children and adolescents had greater risk of suboptimal health (adjusted risk ratio [ARR], 1.4 and 1.7; P < .01), use of prescriptions (ARR, both 1.1; P = .01), and emergency department visits (ARR, 1.2 and 1.1; P = .01); overweight children/adolescents had lower mean out-of-pocket expenditures (∼$100, P < .01); and obese children/adolescents had greater risk of emotional/behavioral problems (ARR, 1.2; P < .01) and specialist visits (ARR, 1.1; P = .01). The most common specialty referral among obese children/adolescents was psychiatry. Overweight and obesity were not associated with office visits or total expenditures. A greater proportions of children and adolescents with suboptimal health and emotional/behavioral problems had health care expenditures, and those with suboptimal health were more likely to have out-of-pocket expenditures.
Pediatric overweight and obesity affect child and adolescent health status, emotional/behavioral problems, and specific domains of health care utilization, but do not appear to be associated with total health care expenditures. Out-of-pocket expenditures are lower among overweight children and adolescents. These findings highlight the need for early intervention in overweight children/adolescents, when health care expenditures may not be greater, and suggest that it may prove useful to pay special attention to the health status and emotional/behavioral problems of overweight and obese children/adolescents in weight-management interventions.
在一个由 10 至 17 岁儿童和青少年组成的全国性样本中，研究超重/肥胖与健康、医疗保健利用和支出的关系。
对 2005 年至 2009 年医疗支出面板调查数据（n = 17224）进行二次分析。结果测量包括健康状况不佳、情绪/行为问题、医疗保健利用和支出。
超重和肥胖的儿童和青少年健康状况不佳的风险更高（调整后的风险比 [ARR]，1.4 和 1.7；P<.01），使用处方（ARR，均为 1.1；P=.01）和急诊就诊（ARR，分别为 1.2 和 1.1；P=.01）；超重儿童/青少年的自付支出平均值较低（约 100 美元，P<.01）；肥胖儿童/青少年情绪/行为问题的风险更高（ARR，1.2；P<.01）和专科就诊（ARR，1.1；P=.01）。肥胖儿童/青少年最常见的专科转介是精神病学。超重和肥胖与门诊就诊或总支出无关。健康状况不佳和情绪/行为问题较多的儿童和青少年的医疗保健支出比例较高，健康状况不佳的儿童和青少年更有可能自付支出。
儿科超重和肥胖会影响儿童和青少年的健康状况、情绪/行为问题以及特定的医疗保健利用领域，但似乎与总医疗保健支出无关。超重儿童和青少年的自付支出较低。这些发现强调了在儿童超重时进行早期干预的必要性/青少年，当医疗保健支出可能不会更高时，这表明在体重管理干预中特别关注超重和肥胖儿童/青少年的健康状况和情绪/行为问题可能会有所帮助。
