The prevalence and health care use of overweight children in an integrated health care system.

OBJECTIVE To determine the prevalence, health care use, and costs of overweight children when compared with healthy-weight children. DESIGN Longitudinal cohort. SETTING Kaiser Permanente Colorado is an integrated, nonprofit health care system. Patients Eleven thousand six hundred thirty-six children who completed at least 1 body mass index (calculated as weight in kilograms divided by height in meters squared) assessment between 2000 and 2004. MAIN EXPOSURE Overweight. MAIN OUTCOME MEASURE Health care use. Based on previous research that demonstrated a higher cost for obese adults when compared with healthy-weight adults, we hypothesized that, when compared with healthy-weight children, overweight children would have higher health care use patterns. RESULTS Thirteen percent and 14% of the sample, respectively, were classified as overweight or at risk of becoming overweight. At both year 1 (rate ratio [RR] = 1.11 [95% confidence interval (CI), 1.06-1.17]) and year 3 (RR = 1.06 [95% CI, 1.01-1.11]), overweight children had significantly more internal Kaiser Permanente Colorado medical visits, although the magnitude of the relationship was relatively small. Of particular note was the relationship between being overweight and increased use of mental health resources at both points (year 1 RR = 1.47; year 3 RR = 1.48). The calculated additional annual cost of use for 1000 overweight children (regression adjusted to control for comorbidities) was approximately $42 000 for primary care sick visits and $32 000 for mental health visits. CONCLUSION There is potential for cost savings or cost realignment with weight-management interventions from dollars that could be saved through the reduction of childhood overweight.