New research presented at this year's European Congress on Obesity (ECO) in Glasgow, Scotland (28 April - 1 May) reveals that obese children are over a third more likely to require a hospital emergency department visit than their normal weight counterparts. The research was conducted by Taimoor Hasan of the Department of Health Sciences, University of York, York, UK, and colleagues.
Overweight and obese individuals are known to be at an increased risk of developing a number of potentially very serious medical conditions, and this elevated morbidity leads to an increased use of health services. Unlike adult obesity, little is known about the healthcare burden of excess weight in children, so in this new study, the authors sought to analyse the association between being overweight or obese with the level of health service utilisation in childhood.
The team based their analysis on observational studies selected from a number of databases of medical research (MEDLINE, EMBASE, PubMed, Web of Science and CINAHL) up to June 2018. Any which assessed the impact of being overweight or obese on health service use by children (age 0-18 years) were selected for further detailed study.
Thirty-five studies were eligible for this review. These studies reported on different measures of health service utilisation. Thirteen studies reported on outpatient visits, nine on emergency department (ED) visits, five on hospital admission, and four on hospital length of stay. Only seven of these studies reported sufficient data to be included in the meta-analysis - six from the USA and one from Canada.
The authors found that when compared to healthy weight children, those who were obese were on average 36% more likely to visit a hospital emergency department, while overweight children were 17% more likely to use emergency services. Obesity was also found to be associated with an average 9% increase in visits to outpatient services, although this was only borderline statistically significant.
The researchers observed that for other health service measures such as hospital admission rate or length of stay, the association with excess weight was mixed. Some studies reported an increase, while others reported a decrease in health service utilisation.
Across all the eligible studies, the researchers found an increase in the use of emergency department and outpatient services by obese and overweight children, although the strength of association between child weight and the likelihood of a visit was variable.
The authors conclude: "This review and meta-analysis identified an increased use of emergency and outpatient services in obese children. Across the seven studies combined, children with obesity had a 36% increased risk the risk of visiting the emergency department compared with normal weight children."
They add: "This review also identified that health service use is defined by different parameters and further research is required to better understand the association of childhood obesity with these broad range of parameters."