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Healthcare utilisation and expenditure of overweight and non-overweight children
  1. Alet H Wijga1,
  2. Sigrid M Mohnen1,
  3. Judith M Vonk2,
  4. Ellen Uiters1
  1. 1Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
  2. 2Department of Epidemiology, Groningen Research Institute for Asthma and COPD (GRIAC), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
  1. Correspondence to Dr Alet H Wijga, Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven 3720 BA, The Netherlands; alet.wijga{at}rivm.nl

Abstract

Background Quantification of the burden of overweight on the healthcare system is becoming increasingly urgent for health policy, but accurate estimates are hard to obtain.

Methods In order to assess healthcare utilisation and expenditure of overweight and non-overweight children, we linked, on an individual basis, data on body mass index from a birth cohort study with administrative health insurance claims data. In children aged 14–15 years, we compared utilisation and expenditure on general practice care, dental care, hospital/specialist care, prescribed medication, allied healthcare and mental healthcare of overweight children (overweight at age 11 and 14, n=80) and non-overweight children (no overweight at age 11 and 14, n=1253).

Results For overweight children, mean 1-year healthcare expenditure was €837 per child and for non-overweight children €616. This difference was mainly due to significant differences in utilisation of hospital care (49% vs 37%) and mental healthcare (14% vs 7%) and to a lesser extent to higher expenditure per user.

Conclusion Our results indicate the potential value of linking survey data to claims data in order to obtain insight into the healthcare costs of childhood overweight. Further studies should elucidate whether the observed differences are causally related to overweight.

  • obesity
  • child health
  • health services

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/jech-2017-210222

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    Footnotes

    • Contributors AHW contributed to the design of the PIAMA birth cohort and supervised data collection and management. AHW, SMM and EU conceived the design of this study. AHW and EU collaborated with Statistics Netherlands to establish the data linkage. SMM analysed the data. AHW wrote the first draft of the paper. All authors critically reviewed the manuscript, were involved in finalising the paper and had final approval of the submitted version.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent Not required.

    • Ethics approval Ethics approval for the PIAMA study was obtained from the Ethics Committees of the participating Institutes: Rotterdam, MEC (Medisch Ethische Commisie Erasmus Universiteit Rotterdam/Academische Ziekenhuizen Rotterdam) 132.636/1994/39, 13 June 1994 and 137.326/1994/130, 16 February 1995. Groningen, MEC (Medisch Ethische Commisie Academisch ziekenhuis Groningen) 94/08/92, 26 August 1994. Utrecht/Bilthoven, MEC-TNO (Medisch Ethische Commisie-Toegepast Natuurwetenschappelijk Onderzoek) 95/50, 28 February 1996 (METC_TNO_UtrechtBilthoven_95_50.pdf).

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement Data from the PIAMA birth cohort study are available on request. Requests can be submitted to the PIAMA Principal Investigators. Their names and email addresses are listed on the PIAMA website (http://piama.iras.uu.nl/index-en.php#collaboration). The PIAMA data are not freely accessible in the public domain because this would be in conflict with the agreement between the PIAMA study team and the PIAMA participants. The information participants received at the start of the study (in 1996–1997) included the statement ’the information that we receive from you will only be used for the PIAMA project' and participants gave written informed consent based on this information.