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.
Acknowledgements
The authors would like to thank Charmaine Cooke and Yan Wang from the Population Health Research Unit, Dalhousie University, for their assistance with data provision and access.
Funding
Support for administrative data linkage was provided by a Canada Foundation for Innovation Leaders Opportunity Fund award to S. F. L. Kirk. S. F. L. Kirk is supported through a Canada Research Chair in Health Services Research. The CLASS project was funded through a Canadian Population Health Initiative operating grant. P. J. Veugelers is supported through a Canada Research Chair in Population Health and an Alberta Heritage Foundation for Medical Research Health Scholarship. Y. Yasui is supported through a Canada Research Chair in Biostatistics.
Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.