Does high BMI influence hospital charges in children undergoing adenotonsillectomy?
BACKGROUND
Obesity is a highly prevalent chronic problem with health and fiscal consequences. Data from adults and nonsurgical pediatric patients suggest that obesity has serious implications for the US economy.


OBJECTIVE
Our goal was to describe the impact of BMI on hospital charges in children undergoing adenotonsillectomy (AT).


METHODS
We carried out a retrospective comparative analysis of the electronic anesthesia record and the charges from billing data from a large tertiary institution on children aged 3-18 years who had AT during the year 2005-2007. The main outcome measures were mean total hospital charges, likelihood of admission, and length of hospital stay (LOS).


RESULTS
Of 1,643 children, 68.9% were aged <10 years, 76% were whites, and 74.1% had private commercial insurance. Most (75.3%) children were discharged on the day of surgery. Obese and overweight children were more likely to be admitted than their normal-weight peers (X(2)=26.3, P<0.001). Among those admitted, BMI showed a positive correlation with LOS (r=0.20, P<0.001). Obese and overweight patients had significantly higher total hospital charges than their healthy-weight counterparts (P=0.001). Anesthesia, postanesthesia care unit (PACU), and pharmacy and laboratory charges were also higher for obese than normal-weight children (P<0.05).


CONCLUSIONS
Overweight and obese children undergoing AT accrued higher hospital charges and had longer postoperative LOS than their healthy-weight peers. If these findings are extendable to other surgical procedures, they could have far-reaching implications for the US economy.
Nafiu
Olubukola O
OO
Department of Anesthesiology, University of Michigan, Ann Arbor, Michigan, USA. onafiu@med.umich.edu
Chimbira
Wilson T
WT
Woolford
Susan J
SJ
Tremper
Kevin K
KK
Reynolds
Paul I
PI
Green
Glenn E
GE
D000233:Adenoidectomy / Q000191:economics*; D000293:Adolescent; D000761:Anesthesia Department, Hospital / Q000191:economics; D000762:Anesthesia Recovery Period; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D019411:Clinical Laboratory Techniques / Q000191:economics; D005260:Female; D017722:Hospital Charges; D006801:Humans; D007902:Length of Stay / Q000191:economics; D008297:Male; D015999:Multivariate Analysis; D009765:Obesity / Q000191:economics* / Q000503:physiopathology / Q000601:surgery; D009873:Operating Rooms / Q000191:economics; D050177:Overweight / Q000191:economics* / Q000503:physiopathology / Q000601:surgery; D010343:Patient Admission / Q000191:economics; D010607:Pharmacy Service, Hospital / Q000191:economics; D012189:Retrospective Studies; D014068:Tonsillectomy / Q000191:economics*