Abstract
Objective
We tested the hypothesis that the frequency of emergency department (ED) visits, outpatient
clinic visits, and hospitalizations were higher among children with higher body mass
index (BMI) categories, even after controlling for demographics, socioeconomic status,
and presence of other chronic medical conditions.
Methods
We obtained electronic height, weight, and utilization data for all residents of Olmsted
County, Minnesota, aged 2 to 18 years on January 1, 2005 (n = 34,335), and calculated
baseline BMI (kg/m2). At least 1 BMI measurement and permission to use medical record information was
available for 19,771 children (58%); 19,528 with follow-up comprised the final cohort.
BMIs were categorized into underweight/healthy weight (<85th percentile), overweight
(85th to <95th percentile), and obese (≥95th percentile). Negative binomial models
were used to compare the rate of utilization across BMI categories. Multivariable
models were used to adjust for the effects of age, race, sex, socioeconomic status,
and chronic medical conditions.
Results
Compared to children with BMI <85th percentile, overweight and obese status were associated
with increased ED visits (adjusted incident rate ratio [IRR] 1.16, 95% confidence
interval [CI] 1.10, 1.23; and IRR 1.27, 95% CI 1.19, 1.35, respectively; P for trend <.0001), and outpatient clinic visits (IRR 1.05, 95% CI 1.02, 1.08; and
IRR 1.07, 95% CI 1.04, 1.11, respectively; P for trend <.0001). No associations were observed between baseline BMI category and
hospitalizations in the adjusted analyses.
Conclusions
Children who are overweight or obese utilize the ED and outpatient clinics more frequently
than those who are underweight/healthy weight, but are not hospitalized more frequently.
Keywords
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Article info
Publication history
Published online: August 27, 2015
Accepted:
August 22,
2015
Received:
February 28,
2015
Footnotes
The authors declare that they have no conflict of interest.
Identification
Copyright
© 2015 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.
