title: The impact of overweight and obesity on pediatric medical expenditures.
abstract: BACKGROUND
  Published studies do not consistently find overweight and obesity to be associated with higher medical expenditures for US children. Previous analyses use varying samples and methods, making results difficult to compare.
  
  
  OBJECTIVE
  To examine whether methodological choices or temporal trends are driving differences in estimates of the association between weight and pediatric medical expenditures.
  
  
  METHODS
  We analyzed the medical expenditures and use of 6- to 17-year-old individuals in the 2006-2010 US Medical Expenditure Panel Surveys. The impact of overweight and obesity on annual medical expenditures and use was assessed, controlling for age, income, race, sex, geographic region, urban/rural residency, insurance status, and survey year. A two-part regression model, in which part one estimated the likelihood of incurring any expenditure and part two estimated non-zero expenditures, was used to predict total expenditures. Expenditures were inflated to 2012 dollars using the medical care component of the Consumer Price Index. Poisson and logistic regression models were used to predict differences in healthcare use between normal weight, overweight, and obese youth.
  
  
  RESULTS
  We found that overweight and obese youth have higher, but not significantly higher medical expenditures than normal weight youth. Conclusions were robust to various methodological assumptions. We found that obese adolescents have a higher use of prescriptions drugs and healthcare visits compared with normal weight youth (0.04-1.3 visits), but differences in use only translated into marginally higher expenditures.
  
  
  CONCLUSIONS
  These findings may reflect new trends in healthcare use among obese youth. Future research should assess whether services are being underused by obese youth and the impact of persistent obesity on long-term medical expenditures.
authors.affiliation: Department of Pediatrics, University of Washington, Seattle, WA, USA, davene.wright@seattlechildrens.org.
authors.forename: Davene R
authors.initials: DR
authors.lastname: Wright
authors.forename: Lisa A
authors.initials: LA
authors.lastname: Prosser
mesh_terms: D000293:Adolescent; D000367:Age Factors; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D005102:Health Expenditures / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D018803:Models, Economic; D063766:Pediatric Obesity / Q000191:economics* / Q000453:epidemiology / Q000628:therapy*; D012424:Rural Population / Q000706:statistics & numerical data*; D012737:Sex Factors; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology; D014505:Urban Population / Q000706:statistics & numerical data*