Health Care Utilization by Body Mass Index in a Pediatric Population

Area of Science:

• Pediatrics
• Public Health
• Epidemiology

Background:

• Childhood obesity is a growing public health concern with potential implications for healthcare utilization.
• Understanding the relationship between body mass index (BMI) categories and healthcare service use is crucial for resource allocation and preventive strategies.

Purpose of the Study:

• To investigate whether children in higher body mass index (BMI) categories experience increased emergency department (ED) visits, outpatient clinic visits, and hospitalizations.
• To control for demographic, socioeconomic, and other chronic medical conditions in the analysis.

Main Methods:

• A cohort of 19,528 children aged 2-18 years from Olmsted County, Minnesota, with baseline BMI data was analyzed.
• BMI was categorized into underweight/healthy weight (<85th percentile), overweight (85th to <95th percentile), and obese (≥95th percentile).
• Negative binomial and multivariable regression models were used to compare healthcare utilization rates across BMI categories, adjusting for covariates.

Main Results:

• Overweight and obese children showed significantly higher rates of ED visits compared to underweight/healthy weight children (IRR 1.16 and 1.27, respectively).
• Increased outpatient clinic visits were also associated with overweight and obese status (IRR 1.05 and 1.07, respectively).
• No significant association was found between baseline BMI category and hospitalization rates after adjustment.

Conclusions:

• Overweight and obese children utilize emergency and outpatient services more frequently than their normal-weight peers.
• Higher BMI in children is linked to increased non-hospitalization healthcare visits but not increased hospitalizations.
• These findings highlight the impact of weight status on ambulatory care patterns in pediatric populations.