title: Health status, emotional/behavioral problems, health care use, and expenditures in overweight/obese US children/adolescents.
abstract: OBJECTIVE
  To examine the association of overweight/obesity with health, health care utilization, and expenditures in a national sample of 10- to 17-year-old children and adolescents.
  
  
  METHODS
  Secondary analysis of 2005 to 2009 Medical Expenditure Panel Survey data (n = 17,224). Outcome measures included suboptimal health, emotional/behavioral problems, health care utilization, and expenditures.
  
  
  RESULTS
  Overweight and obese children and adolescents had greater risk of suboptimal health (adjusted risk ratio [ARR], 1.4 and 1.7; P < .01), use of prescriptions (ARR, both 1.1; P = .01), and emergency department visits (ARR, 1.2 and 1.1; P = .01); overweight children/adolescents had lower mean out-of-pocket expenditures (∼$100, P < .01); and obese children/adolescents had greater risk of emotional/behavioral problems (ARR, 1.2; P < .01) and specialist visits (ARR, 1.1; P = .01). The most common specialty referral among obese children/adolescents was psychiatry. Overweight and obesity were not associated with office visits or total expenditures. A greater proportions of children and adolescents with suboptimal health and emotional/behavioral problems had health care expenditures, and those with suboptimal health were more likely to have out-of-pocket expenditures.
  
  
  CONCLUSIONS
  Pediatric overweight and obesity affect child and adolescent health status, emotional/behavioral problems, and specific domains of health care utilization, but do not appear to be associated with total health care expenditures. Out-of-pocket expenditures are lower among overweight children and adolescents. These findings highlight the need for early intervention in overweight children/adolescents, when health care expenditures may not be greater, and suggest that it may prove useful to pay special attention to the health status and emotional/behavioral problems of overweight and obese children/adolescents in weight-management interventions.
authors.affiliation: Division of General Pediatrics, Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX 75390-9063, USA. christy.turer@utsouthwestern.edu
authors.forename: Christy Boling
authors.initials: CB
authors.lastname: Turer
authors.forename: Hua
authors.initials: H
authors.lastname: Lin
authors.forename: Glenn
authors.initials: G
authors.lastname: Flores
mesh_terms: D000293:Adolescent; D002648:Child; D005260:Female; D005102:Health Expenditures / Q000706:statistics & numerical data*; D006296:Health Services / Q000191:economics / Q000706:statistics & numerical data*; D006304:Health Status; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D009765:Obesity / Q000453:epidemiology*; D009819:Office Visits / Q000191:economics / Q000706:statistics & numerical data; D050177:Overweight / Q000453:epidemiology; D014481:United States / Q000453:epidemiology