Predictors of Inpatient Hospital Cost and Length of Stay Associated with Childhood Obesity: Analysis of Data from the 2012 KID’s Inpatient Database

Abstract

Introduction: Childhood obesity affects 1 in 6 US children, disproportionately impacting minorities and those from low socioeconomic backgrounds. While prevalence, trends, and risks of childhood obesity are well documented, hospital costs have not been studied at the national level.

Methods: A retrospective analysis of the 2012 Kids' Inpatient Database (HCUP) was analyzed to identify length of stay (LOS) and cost per hospital inpatient discharge for children age 2 to 18 years with a secondary diagnosis of obesity. Descriptive statistics for hospital and patient characteristics identified, binary variables were analyzed using the Student's t-test, and variables with multiple categories were analyzed using simple linear regression. Significant variables (P<.05) were included in a multi-variable regression analysis. Results: A total of 52,566 children with obesity were included in the study, with a mean age of 13 years. Most (60%) were male, 42% were White, 25% were African-American, and 25% were Hispanics. Approximately 75% of children were admitted to a teaching hospital, 58% were funded by Medicaid, and 68% were admitted to a large hospital. The average LOS was 4.1 days and the average cost per discharge was $8,396. Patients aged 11 to 18 had the highest LOS, and patients aged 5 to 10 had the highest cost per discharge. White and Hispanic patients had a higher cost per discharge than African-American patients, and Whites had higher LOS. Higher costs were associated with teaching hospitals, hospitals with small bed size, weekday admission, diabetes diagnosis, higher household income, stays with operating room procedures, and hospitals located in the western region. Predictors explained 60.3% of variation in cost per discharge. Discussion: Inpatient hospital costs for children with a secondary diagnosis of obesity are significant. Policies and programs to reducing childhood obesity target decreased morbidity and mortality; however, they also present an opportunity for costs savings.