TY - JOUR
T1 - Incremental charges, costs, and length of stay associated with obesity as a secondary diagnosis among pregnant women
AU - Trasande, Leonardo
AU - Lee, Menjean
AU - Liu, Yinghua
AU - Weitzman, Michael
AU - Savitz, David
PY - 2009/10
Y1 - 2009/10
N2 - BACKGROUND:: Elevation in prepregnancy body mass index (BMI) has been linked to a host of perinatal complications, but increases in charges or costs associated with obesity during pregnancy have not been quantified. METHODS:: To evaluate the economic impact of obesity as a diagnosis on hospitalizations of pregnant women, we performed descriptive, univariate, and multivariable analysis of the 1999 to 2005 Nationwide Inpatient Sample, a nationally representative sample of admissions to US community hospitals. RESULTS:: Hospitalizations with a diagnosis of obesity were rare (0.7%), but when obesity was a diagnosis, it was associated with significant increases in length of stay (LOS), charges, and costs. Cesarean section was more frequent among women hospitalized with a diagnosis of obesity, with increases in this procedure across nearly every pregnancy-related diagnostic category. Controlled for cesarean section, diagnosed obesity was associated with significant increases in LOS (0.55 day), charges ($2015), and costs ($1805). Increases in LOS were sustained across nearly every diagnostic category when cesarean section was incorporated into the modeling, whereas increased cesarean section explained increases in costs for hemorrhage during pregnancy and abnormal glucose tolerance during pregnancy. DISCUSSION:: Although these hospitalizations represent a relatively small sample of all obese pregnant women, diagnosed obesity seems to contribute heavily to increased costs among pregnant women. Further studies are needed to identify reasons increased health care costs of caring for women with obesity during pregnancy besides increased cesarean section. These data may encourage insurers to provide fiscal incentives to prevent complications of obesity during pregnancy.
AB - BACKGROUND:: Elevation in prepregnancy body mass index (BMI) has been linked to a host of perinatal complications, but increases in charges or costs associated with obesity during pregnancy have not been quantified. METHODS:: To evaluate the economic impact of obesity as a diagnosis on hospitalizations of pregnant women, we performed descriptive, univariate, and multivariable analysis of the 1999 to 2005 Nationwide Inpatient Sample, a nationally representative sample of admissions to US community hospitals. RESULTS:: Hospitalizations with a diagnosis of obesity were rare (0.7%), but when obesity was a diagnosis, it was associated with significant increases in length of stay (LOS), charges, and costs. Cesarean section was more frequent among women hospitalized with a diagnosis of obesity, with increases in this procedure across nearly every pregnancy-related diagnostic category. Controlled for cesarean section, diagnosed obesity was associated with significant increases in LOS (0.55 day), charges ($2015), and costs ($1805). Increases in LOS were sustained across nearly every diagnostic category when cesarean section was incorporated into the modeling, whereas increased cesarean section explained increases in costs for hemorrhage during pregnancy and abnormal glucose tolerance during pregnancy. DISCUSSION:: Although these hospitalizations represent a relatively small sample of all obese pregnant women, diagnosed obesity seems to contribute heavily to increased costs among pregnant women. Further studies are needed to identify reasons increased health care costs of caring for women with obesity during pregnancy besides increased cesarean section. These data may encourage insurers to provide fiscal incentives to prevent complications of obesity during pregnancy.
KW - Economic analysis
KW - Hospitalization charges
KW - Obesity
KW - Pregnancy complications
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U2 - 10.1097/MLR.0b013e31819c94b8
DO - 10.1097/MLR.0b013e31819c94b8
M3 - Article
C2 - 19820612
AN - SCOPUS:70349655702
SN - 0025-7079
VL - 47
SP - 1046
EP - 1052
JO - Medical care
JF - Medical care
IS - 10
ER -