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儿童肥胖与医疗保健利用:来自奥地利行政数据的实证证据。

Childhood Obesity and Health Care Utilization: Empirical Evidence from Austrian Administrative Data.

机构信息

Institute of Health Sciences, University of Leeds School of Medicine, Leeds, United Kingdom.

Department of Economics, Johannes Kepler University Linz, Linz, Austria.

出版信息

Child Obes. 2023 Sep;19(6):391-398. doi: 10.1089/chi.2022.0011. Epub 2022 Sep 13.

DOI:10.1089/chi.2022.0011
PMID:36103290
Abstract

Increases in pediatric obesity have been associated with higher levels of health care utilization. There is currently a lack of knowledge on the therapeutic drivers of increased health care use. To examine the association between different measures of health care utilization and BMI among children. We linked cross-sectional administrative data from a regional health insurance fund in Austria with objectively measured BMI from routine school health examinations in 6-15-year-old children ( = 13,493). Differences in probabilities of annual health care utilization (drug prescriptions by therapeutic classification, physician visits by medical specialty, and hospitalizations) were compared between children with normal weight, overweight, or obesity using Probit regressions. Children with obesity had a 1.6 and 8.6 percentage points (pp) higher probability of outpatient doctor visits and prescribed medication, respectively (all  < 0.05). Children with overweight were intermediate. There was a higher probability of consulting a general practitioner, pediatrician, or orthopedist, and higher levels of prescribing for children with obesity across most common drug groups. Children with obesity were ∼40% more likely to receive medication for musculoskeletal and for mental health problems. This was reflected in orthopedic clinic appointments but not in psychology clinics. There were no major differences by gender or age, or parental socioeconomic status. Our data show clear and objective evidence of higher health care utilization by children with obesity. This highlights the importance of policy interventions to curb obesity in children and young people.

摘要

儿科肥胖症的增加与更高水平的医疗保健利用有关。目前,对于增加医疗保健使用的治疗驱动因素知之甚少。为了研究不同医疗保健利用措施与儿童 BMI 之间的关系。我们将奥地利一个地区性健康保险基金的横断面行政数据与 6-15 岁儿童常规学校健康检查中的客观测量 BMI 联系起来( = 13493)。使用 Probit 回归比较了正常体重、超重和肥胖儿童的年度医疗保健利用概率(按治疗分类的药物处方、按医疗专业的医生就诊次数和住院治疗)差异。肥胖儿童的门诊医生就诊和处方药物的可能性分别高出 1.6 和 8.6 个百分点(均 < 0.05)。超重儿童处于中间水平。肥胖儿童更有可能咨询全科医生、儿科医生或矫形外科医生,并且在大多数常见药物类别中,为肥胖儿童开处方的水平更高。肥胖儿童更有可能接受肌肉骨骼和心理健康问题的药物治疗。这反映在矫形外科诊所预约中,但在心理学诊所中没有反映。性别、年龄或父母社会经济地位没有明显差异。我们的数据清楚而客观地表明肥胖儿童的医疗保健利用率更高。这凸显了政策干预以遏制儿童和年轻人肥胖的重要性。

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