Obesity Surgery for Children Rises

AP 6mar2007

CHICAGO — The number of U.S. children having obesity surgery has tripled in recent years, surging at a pace that could mean more than 1,000 such operations this year, new research suggests.

While the procedure is still far more common in adults, it appears to be slightly less risky in teens, according to an analysis of data on 12- to 19-year-olds who had obesity surgery from 1996 through 2003.

During that time, an estimated 2,744 youngsters nationwide had the operations. The pace tripled between 2000 and 2003, reaching 771 surgeries that year, the study found.

Youngsters had slightly shorter hospital stays than adults and none died in the hospital during the study period. By contrast, there were 212 in-hospital deaths out of an estimated 104,702 adults who underwent obesity surgery in 2003, or a rate of 0.2 percent, the study found.

Researchers at Robert Wood Johnson Medical School in New Brunswick, N.J., and Cincinnati Children's Hospital Medical Center analyzed a database of U.S. hospital patients. Obesity surgeries in children during the eight-year period and adults in 2003 were included in the analysis.

The study appeared in yesterday's Archives of Pediatrics & Adolescent Medicine [Abstract below].

About 5% of children and adults had major complications, mostly respiratory problems. Children spent an average of about 3.2 days in the hospital in 2003, as opposed to 3.5 days for adults. Total hospital charges also were lower for pediatric patients, $30,804 per patient versus $36,056 for adults.

The youngest patients were age 12, but most were older teens.

Abstract

The Prevalence and Health Care Use of
Overweight Children in an
Integrated Health Care System

Paul A. Estabrooks, PhD; Susan Shetterly, MS

Arch Pediatr Adolesc Med. 2007;161:222-227.

Objective To determine the prevalence, health care use, and costs of overweight children when compared with healthy-weight children.

Design Longitudinal cohort.

Setting Kaiser Permanente Colorado is an integrated, nonprofit health care system.

Patients Eleven thousand six hundred thirty-six children who completed at least 1 body mass index (calculated as weight in kilograms divided by height in meters squared) assessment between 2000 and 2004.

Main Exposure Overweight.

Main Outcome Measure Health care use. Based on previous research that demonstrated a higher cost for obese adults when compared with healthy-weight adults, we hypothesized that, when compared with healthy-weight children, overweight children would have higher health care use patterns.

Results Thirteen percent and 14% of the sample, respectively, were classified as overweight or at risk of becoming overweight. At both year 1 (rate ratio [RR] = 1.11 [95% confidence interval (CI), 1.06-1.17]) and year 3 (RR = 1.06 [95% CI, 1.01-1.11]), overweight children had significantly more internal Kaiser Permanente Colorado medical visits, although the magnitude of the relationship was relatively small. Of particular note was the relationship between being overweight and increased use of mental health resources at both points (year 1 RR = 1.47; year 3 RR = 1.48). The calculated additional annual cost of use for 1000 overweight children (regression adjusted to control for comorbidities) was approximately $42 000 for primary care sick visits and $32 000 for mental health visits.

Conclusion There is potential for cost savings or cost realignment with weight-management interventions from dollars that could be saved through the reduction of childhood overweight.

Author Affiliations: Clinical Research Unit, Kaiser Permanente Colorado, Denver.

source: 6may2007