Obesity is a growing problem, with 17% of US children considered obese in 2010. Obesity is associated with increased hospital complications, length of stay and cost among adults. Similar trends are found among hospitalized pediatric patients as identified by ICD-9 coding, but ICD-9 coding underestimates true prevalence of obesity as opposed to using calculated BMI to identify obese patients. The objective of this study was to compare the length of stay and cost for normal weight, overweight, and obese pediatric patients based on body mass index (BMI) on hospital admission.
Our study was a retrospective chart review of patients aged 2 through 18 years admitted between May 2009 and January 2012 at a children’s hospital. Analysis was limited to the top 20 most common primary diagnostic codes. Medically complex children were excluded. Length of hospital stay and hospital costs were compared for obese, overweight and normal weight patients while controlling for age, gender, insurance type, and diagnosis using logistic regression analysis.
730 patients were included for analysis. Obesity rate was 18%, comparable to national trends. When controlled for age, gender, insurance type, and primary diagnosis, obese patients were significantly more likely to have a hospital length of stay longer than the median (odds ratio 1.72, confidence interval 1.07-2.77, p=0.025) and had significantly higher median hospital costs ($1,014 higher, confidence interval $144-$1,895, p=0.024) compared to normal weight patients. No significant difference in length of stay or hospital costs were found when comparing obese patients by different diagnoses.
Hospitalized pediatric obese patients, as identified by measured BMI upon admission, are significantly more likely to have a longer length of hospital stay and have significantly greater median hospital costs compared to normal weight patients. The growing epidemic of childhood obesity must be addressed to prevent increased burdens on our healthcare system. Further research is needed to see if this is a nationwide trend and to study the factors associated with the increased length of stay and hospital costs in obese patients.