The Journal of Pediatrics
Volume 154, Issue 3 , Pages 327-331 , March 2009

Obesity Identified by Discharge ICD-9 Codes Underestimates the True Prevalence of Obesity in Hospitalized Children

  • Jessica G. Woo, PhD

      Affiliations

    • Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
    • University of Cincinnati College of Medicine, Cincinnati, OH
    • Corresponding Author InformationReprint requests: Jessica G. Woo, PhD, Assistant Professor of Pediatrics, Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, MLC 5041, Cincinnati, OH 45229-3039
    • ,
  • Meg H. Zeller, PhD

      Affiliations

    • Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
    • University of Cincinnati College of Medicine, Cincinnati, OH
    • ,
  • Kimberly Wilson, MS

      Affiliations

    • Translational Research Trials Office, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
    • ,
  • Thomas Inge, MD, PhD

      Affiliations

    • Division of General and Thoracic Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
    • University of Cincinnati College of Medicine, Cincinnati, OH

Received 18 March 2008 ,Revised 28 July 2008 ,Accepted 10 September 2008.

References 

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  2. Heithoff KA, Cuffel BJ, Kennedy S, Peters J. The association between body mass and health care expenditures. Clin Ther. 1997;19:811–820
  3. Quesenberry CP, Caan B, Jacobson A. Obesity, health services use, and health care costs among members of a health maintenance organization. Arch Intern Med. 1998;158:466–472
  4. Wang G, Dietz WH. Economic burden of obesity in youths aged 6 to 17 years: 1979-1999. Pediatrics. 2002;109:e81
  5. Centers for Disease Control and Prevention. A SAS program for the CDC Growth Charts. www.cdc.gov/nccdphp/dnpa/growthcharts/sas.htmAccessed Dec 3, 2002
  6. Centers for Disease Control and Prevention. Cut-offs to define outliers in the 2000 CDC Growth Charts. http://www.cdc.gov/nccdphp/dnpa/growthcharts/00binaries/BIV-cutoffs.pdfAccessed Jan 13, 2007
  7. Institute of Medicine. Expert Committee Recommendations on the Assessment, Prevention and Treatment of Child and Adolescent Overweight and Obesity. http://www.ama-assn.org/ama1/pub/upload/mm/433/ped_obesity_recs.pdfAccessed Jul 26, 2007
  8. Healthcare Cost and Utilization Project (HCUP). Clinical Classifications Software (CCS) for ICD-9-CM, 2007. http://www.hcup-us.ahrq.gov/toolssoftware/ccs/ccs.jspAccessed May 5, 2007
  9. Woolford SJ, Gebremariam A, Clark SJ, Davis MM. Incremental hospital charges associated with obesity as a secondary diagnosis in children. Obesity (Silver Spring). 2007;15:1895–1901
  10. Hampl SE, Carroll CA, Simon SD, Sharma V. Resource utilization and expenditures for overweight and obese children. Arch Pediatr Adolesc Med. 2007;161:11–14
  11. Dorsey KB, Wells C, Krumholz HM, Concato JC. Diagnosis, evaluation, and treatment of childhood obesity in pediatric practice. Arch Pediatr Adolesc Med. 2005;159:632–638
  12. O'Connor J, Youde LS, Allen JR, Baur LA. Obesity and under-nutrition in a tertiary paediatric hospital. J Paediatr Child Health. 2004;40:299–304
  13. Buescher PA, Whitmire JT, Plescia M. Relationship between body mass index and medical care expenditures for North Carolina adolescents enrolled in Medicaid in 2004. Prev Chronic Dis. 2008;5:A04
  14. Janicke DM, Harman JS, Kelleher KJ, Zhang J. Psychiatric diagnosis in children and adolescents with obesity-related health conditions. J Dev Behav Pediatr. 2008;29:276–284
  15. Janicke DM, Harman JS, Kelleher KJ, Zhang J. The association of psychiatric diagnoses, health service use, and expenditures in children with obesity-related health conditions. J Pediatr Psychol. 2008;Jun 3 Epub ahead of print
  16. Patel NC, Hariparsad M, Matias-Akthar M, Sorter MT, Barzman DH, Morrison JA, et al. Body mass indexes and lipid profiles in hospitalized children and adolescents exposed to atypical antipsychotics. J Child Adolesc Psychopharmacol. 2007;17:303–311

 Supported by the authors' divisions at Cincinnati Children's Hospital Medical Center. The authors disclose no conflicts of interest.

PII: S0022-3476(08)00784-1

doi: 10.1016/j.jpeds.2008.09.022

The Journal of Pediatrics
Volume 154, Issue 3 , Pages 327-331 , March 2009

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