title: Use and cost of health services among overweight and obese Canadian children.
abstract: BACKGROUND
  Along with a dramatic rise in the rates of childhood obesity, obesity-related disorders, such as type 2 diabetes, hypertension, and obstructive sleep apnea, are seen with increasing frequency in children. As a consequence, overweight and obese children may use health care services more often than their normal weight peers. The aim of the current study was to assess health service use and costs across categories of weight status.
  
  
  METHODS
  Prospective cohort study using data from a population-based survey among grade 5 children in the Canadian province of Nova Scotia linked with administrative health data, using a combination of deterministic and probabalistic matching (n = 4 380). Total health care costs (physician and hospital costs), lifetime (up to age 14 years) physician costs and number of physician visits were assessed in a series of multiple regression models.
  
  
  RESULTS
  There was a gradient for higher costs and utilization across the three weight groups. Total health care costs in the three years following the survey were 21% (95% CI: 2-43) higher in obese children compared with normal weight children. Obese children also had significantly higher lifetime physician costs and more physician visits than their normal weight peers. The health care cost trajectories of normal weight and obese children drift apart as early as 3 years of age. Interpretation. Obese children in the Canadian province of Nova Scotia have significantly higher health care costs and more physician visits and specialist referrals than their normal weight peers, highlighting the need for cost-effectiveness studies of obesity prevention programs.
authors.affiliation: School of Public Health, University of Alberta, Edmonton, AB, Canada.
authors.forename: Stefan
authors.initials: S
authors.lastname: Kuhle
authors.forename: Sara
authors.initials: S
authors.lastname: Kirk
authors.forename: Arto
authors.initials: A
authors.lastname: Ohinmaa
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Yasui
authors.forename: Alexander C
authors.initials: AC
authors.lastname: Allen
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Veugelers
mesh_terms: D000293:Adolescent; D015992:Body Mass Index; D002170:Canada; D002648:Child; D015331:Cohort Studies; D003695:Delivery of Health Care / Q000706:statistics & numerical data*; D005260:Female; D017048:Health Care Costs; D006801:Humans; D008297:Male; D009765:Obesity / Q000191:economics*; D050177:Overweight / Q000191:economics*; D011446:Prospective Studies; D012044:Regression Analysis; D012959:Socioeconomic Factors