Abstract 853: Medical Costs of Implementing Childhood Obesity Expert Recommendations
Introduction: The childhood obesity epidemic represents a significant risk for future adult cardiovascular disease. The CDC/AMA/HRSA released Expert Recommendations for prevention and treatment of childhood overweight (OW) and obesity (OB) in 2008. Previous studies have been unable to show increased annual costs of pediatric obesity from the outpatient, primary care setting. These studies are limited by under-diagnosis of OW or OB and lack of specific recommendations for lab testing and follow up.
Objective: To report the potential cost and visit burden of implementing the expert recommendations using OB and family history from national data, and current cost data from a national survey of medical expenses.
Hypothesis: Projections for costs and visits will be significantly higher than previous national estimates.
Methods: Nationally representative data from NHANES 1999 –2006 provided the rates of OW/OB youth and Fam Hx to have laboratory testing per the Expert Recommendations. The 2004 – 06 Medical Expenditure Panel Survey provided the medical costs and the existing number of primary care visits for all children. We estimated the additional visits needed for OW and OB 2–18 yr olds seen in a one year period for diagnosis, follow up and management of weight per the Expert Recommendations. STATA software accounted for complex sample design.
Results: In one year, 97.4% of US 2–18 yr olds have a well child visit and 0 –1 follow up visits ($1600/yr) and 2.6% have 2–3 follow up visits (~$4000/yr). According to Expert Recommendations, the OW youth would need 2–7 follow-up visits, OB youth would need 3–7 follow up visits. For lab testing per the Expert Recommendations, 8.6 million OW or OB children 2–10 yr, and 2.2 million OW children without + Fam Hx over 10ys would get a fasting lipid profile ($36.5/ea). The 2.7 million OW youth with + Fam Hx > 10yrs and 5.8 million OB youth > 10 yrs should get a fasting lipid profile, ALT and glucose ($51.1/ea), estimated at nearly $820 million.
Conclusion: Most OW and OB youth would require 1 to 6 additional visits per year by following the Expert Recommendations and there would be a significant increase in lab tests ordered. These estimates represent a significantly higher medical cost of childhood obesity than previously reported.