Use and cost of health services among overweight and obese Canadian children
Use and cost of health services among overweight and obese Canadian children
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DOI：
10.3109/17477166.2010.486834
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发表时间：
2011-04-01
影响因子：
--
通讯作者：
Veugelers, Paul J.
中科院分区：
文献类型：
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作者：
Kuhle, Stefan;Kirk, Sara;Veugelers, Paul J.
背景。随着儿童肥胖率的急剧上升，2型糖尿病、高血压和阻塞性睡眠呼吸暂停等与肥胖相关的疾病在儿童中的发病率也越来越高。因此，超重和肥胖儿童可能比正常体重的同龄人更频繁地使用医疗保健服务。当前研究的目的是评估不同体重状况类别的卫生服务使用情况和成本。方法。前瞻性队列研究使用加拿大新斯科舍省 5 年级儿童的人口调查数据与行政健康数据相结合，采用确定性和概率匹配相结合的方法 (n = 4 380)。通过一系列多元回归模型评估总医疗保健费用（医生和医院费用）、终生（14 岁以下）医生费用和就诊次数。结果。三个重量组之间存在更高的成本和利用率的梯度。调查后三年内，肥胖儿童的总医疗保健费用比正常体重儿童高出 21% (95% CI: 2-43)。与正常体重的同龄人相比，肥胖儿童的终生医疗费用和就诊次数也明显更高。正常体重和肥胖儿童的医疗保健费用轨迹早在 3 岁时就出现了差异。解释。与体重正常的同龄人相比，加拿大新斯科舍省的肥胖儿童的医疗保健费用明显更高，就诊和专科医生转诊的次数也更多，这凸显了对肥胖预防计划进行成本效益研究的必要性。
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.