title: Obesity in children is associated with increased health care use.
abstract: BACKGROUND
  The prevalence of obesity in children has steadily risen during recent years in developed countries. There is increasing data associating this rise in obesity with a rise in morbidity. In adults, data show clear association between obesity and health care use. This study examined the effects of obesity on health care use in children of several age groups.
  
  
  METHODS
  The population consisted of children from Tirat HaCarmel, Israel, who are patients at the town's Clalit Health Care, Child Care Center (CCC). All obese children (body mass index [BMI] > 95%) participated and were matched by age and gender with nonobese children (BMI < 85%) who served as a control group. Children were further divided into 3 age groups: ages 4 to 7 years, 8 to 11 years, and 12 to 18 years. Health care use was measured by 4 criteria over a 2-year time period: clinic visits, emergency department visits, hospitalizations, and medication use.
  
  
  RESULTS
  Of more than 4000 children treated in the CCC, 363 obese children were matched to 382 control children. Obese children had significantly more clinic visits (4942 vs 4058, P < .001), had more hospitalizations (67 vs 34, P < .001), were hospitalized for longer periods (207 vs 79 days, P < .001), and used significantly more medications (5945 vs 4638, P < .001) than did the control group.
  
  
  CONCLUSIONS
  This study provides objective clinical evidence that obesity in children is associated with increased health care use. This information has clear implications for both the public health and health insurance sectors and supports the need to invest in efforts to reduce childhood obesity.
authors.affiliation: Pediatrics Department, Clalit General Health Care, Child Care Center, Tirat Hacarmel, 34349 Israel. ELIEZERHE@clalit.org.il
authors.forename: Elie
authors.initials: E
authors.lastname: Hering
authors.forename: Irena
authors.initials: I
authors.lastname: Pritsker
authors.forename: Ludmila
authors.initials: L
authors.lastname: Gonchar
authors.forename: Giora
authors.initials: G
authors.lastname: Pillar
mesh_terms: D000293:Adolescent; D000553:Ambulatory Care / Q000706:statistics & numerical data; D002648:Child; D002675:Child, Preschool; D004363:Drug Utilization / Q000706:statistics & numerical data; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007557:Israel / Q000453:epidemiology; D008297:Male; D009765:Obesity / Q000453:epidemiology*; D012189:Retrospective Studies