title: Obesity and the use of health care services.
abstract: OBJECTIVE
  This study investigated differences in the use of health care services and associated costs between obese and nonobese patients.
  
  
  METHODS
  New adult patients (N = 509) were randomly assigned to primary care physicians at a university medical center. Their use of medical services and related charges was monitored for 1 year. Data collected included sociodemographics, self-reported health status using the Medical Outcomes Study Short Form-36, evaluation for depression using the Beck Depression Index, and measured height and weight to calculate BMI.
  
  
  RESULTS
  Obese patients included a significantly higher percentage of women and had higher mean age, lower mean education, lower mean health status, and higher mean Beck Depression Index scores. Obese patients had a significantly higher mean number of visits to both primary care (p = 0.0005) and specialty care clinics (p = 0.0006), and a higher mean number of diagnostic services (p < 0.0001). Obese patients also had significantly higher primary care (p = 0.0058), specialty clinic (p = 0.0062), emergency department (p = 0.0484), hospitalization (p = 0.0485), diagnostic services (p = 0.0021), and total charges (p = 0.0033). Controlling for health status, depression, age, education, income, and sex, obesity was significantly related to the use of primary care (p = 0.0364) and diagnostic services (p = 0.0075). There was no statistically significant relationship between obesity and medical expenditures in any of the five categories or for total charges.
  
  
  CONCLUSIONS
  Obesity is a chronic condition requiring long-term management, with an emphasis on prevention. If this critical health issue is not appropriately addressed, the prevalence of obesity and obesity-related diseases will continue to grow, resulting in escalating use of health care services.
authors.affiliation: Department of Family and Community Medicine, University of California, Davis, 4860 "Y" Street, Suite 2300, Sacramento, CA 95817, USA. kdbertakis@ucdavis.edu
authors.forename: Klea D
authors.initials: KD
authors.lastname: Bertakis
authors.forename: Rahman
authors.initials: R
authors.lastname: Azari
mesh_terms: D000328:Adult; D000375:Aging; D015992:Body Mass Index; D003863:Depression; D004522:Educational Status; D005194:Family Practice; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data*; D006304:Health Status; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007182:Income; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications* / Q000191:economics* / Q000628:therapy; D012727:Sex Characteristics