title: Costs of managing conditions associated with obesity among Australian teenagers.
abstract: OBJECTIVE
  To determine the health-care charges associated with monitoring and managing, over 1 year, the cases of elevated insulin concentration, elevated alanine aminotransferase concentration and dyslipidaemia due to overweight or obesity among 15-19-year-old Australian males and females.
  
  
  METHODS
  Fasting blood samples (n= 500) were collected in 2004 from a representative population sample of adolescents (n= 496; mean age 15.3 years) attending schools in Sydney, Australia. Full service charges and Medicare expenditures for specialist medical and dietary consultations, pathology tests and radiological investigations, over 1 year, under efficient and inefficient health-care delivery models, including and excluding participants in the healthy body mass index (BMI) category.
  
  
  RESULTS
  Under an inefficient delivery model and including all participants with elevated risk factors, the Medicare expenditure was $A305.1 million per annum (M pa). Exclusion of participants in the healthy BMI category resulted in an annual Medicare expenditure of $A170.0M pa. Under an efficient delivery model and including all participants with elevated risk factors, the Medicare expenditure was $A295.5M pa. Exclusion of participants in the healthy BMI category reduced annual Medicare expenditure to $A164.8M pa. Medicare expenditure for 15-19-year-olds would increase by 48% if only cases among overweight and obese adolescents were treated and by 85% if all cases were identified and treated.
  
  
  CONCLUSIONS
  Short-term management of the health consequences of overweight and obesity among adolescents will increase Medicare expenditure on this group by at least 48%. Failure to treat will delay, but compound, health-care expenditure.
authors.affiliation: School of Public Health, University of Sydney, Camperdown, NSW 2006, Australia. vivi5@idx.com.au
authors.forename: Michael L
authors.initials: ML
authors.lastname: Booth
authors.forename: Timothy
authors.initials: T
authors.lastname: Dobbins
authors.forename: Robert
authors.initials: R
authors.lastname: Aitken
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Denney-Wilson
authors.forename: Louise L
authors.initials: LL
authors.lastname: Hardy
authors.forename: Anthony D
authors.initials: AD
authors.lastname: Okely
authors.forename: Jacob
authors.initials: J
authors.lastname: George
authors.forename: David
authors.initials: D
authors.lastname: Sullivan
authors.forename: Christopher T
authors.initials: CT
authors.lastname: Cowell
mesh_terms: D000293:Adolescent; D000410:Alanine Transaminase / Q000097:blood; D001315:Australia / Q000453:epidemiology; D015897:Comorbidity; D017281:Cost of Illness; D003955:Diagnostic Tests, Routine / Q000191:economics; D050171:Dyslipidemias / Q000097:blood / Q000191:economics / Q000453:epidemiology; D005215:Fasting; D005260:Female; D005102:Health Expenditures; D006801:Humans; D007328:Insulin / Q000097:blood; D008297:Male; D009313:National Health Programs / Q000191:economics; D009517:New South Wales / Q000453:epidemiology; D009765:Obesity / Q000097:blood / Q000191:economics* / Q000453:epidemiology; D055815:Young Adult
chemical_list: D007328:Insulin; D000410:Alanine Transaminase