Skip to main content
Top
Published in: The European Journal of Health Economics 1/2012

01-02-2012 | Original Paper

The impact of BMI on direct costs in Children and Adolescents: empirical findings for the German Healthcare System based on the KiGGS-study

Author: Christina M. Wenig

Published in: The European Journal of Health Economics | Issue 1/2012

Login to get access

Abstract

Background

Childhood obesity is a growing public health burden. Among German children and adolescents, 15% are overweight (including obese) and 6.3% are obese according to a national reference. This is the first German study to assess aspects of the economic burden associated with overweight and obesity in children and adolescents based on a representative cross-sectional survey.

Methods

Based on the German Interview and Examination Survey for Children and Adolescents (KiGGS), direct costs induced by utilisation of healthcare services (physician and therapist visits, hospital stays) were assessed using a bottom-up approach. To investigate the impact of body mass index (BMI) on costs, univariate analyses were performed and multivariate generalised mixed models were estimated.

Results

Average annual total costs were estimated to be €442 (95% CI [402–486]). Bivariate analysis showed considerable differences between BMI groups in physician costs, but not for hospital or therapist costs. High socioeconomic status, residence in west Germany and underweight had a significant negative impact on total costs in multivariate analysis. The effect of overweight on total costs is positive but not significant; neither is the effect of obesity. However, overweight and obese children exhibit significantly higher physician costs and a higher probability of being high utilisers of healthcare services.

Discussion

The economic implications of overweight and obesity are, to some extent, already visible in childhood. The results suggest that obese children should be classified as priority group for prevention. Despite limitations, this study provides important information concerning the relevance of childhood obesity as a health problem.
Appendix
Available only for authorised users
Footnotes
1
Considering the steepness of the logistic function near zero, this value seems small enough (the minimum of positive costs is €17). Alteration of this value did not affect the results.
 
Literature
1.
go back to reference Kurth, B.-M., Schaffrath Rosario, A.: Die Verbreitung von Übergewicht und Adipositas bei Kindern und Jugendlichen in Deutschland. Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz 50, 736–743 (2007)PubMedCrossRef Kurth, B.-M., Schaffrath Rosario, A.: Die Verbreitung von Übergewicht und Adipositas bei Kindern und Jugendlichen in Deutschland. Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz 50, 736–743 (2007)PubMedCrossRef
2.
go back to reference U.S. Preventive: Services task force: screening and interventions for overweight in children and adolescents: recommendation statement. Am. Fam. Physician 73(1), 115–119 (2006) U.S. Preventive: Services task force: screening and interventions for overweight in children and adolescents: recommendation statement. Am. Fam. Physician 73(1), 115–119 (2006)
3.
go back to reference von Lengerke, T., Happich, M., Reitmeir, P., John, J.: Utilization of out- and inpatient health services by obese adults: a population-based study in the Augsburg region, Germany. Gesundheitswesen 67(Suppl 1), S150–S157 (2005)CrossRef von Lengerke, T., Happich, M., Reitmeir, P., John, J.: Utilization of out- and inpatient health services by obese adults: a population-based study in the Augsburg region, Germany. Gesundheitswesen 67(Suppl 1), S150–S157 (2005)CrossRef
4.
go back to reference von Lengerke, T., Reitmeir, P., John, J.: [Direct medical costs of (severe) obesity: a bottom-up assessment of over- vs. normal-weight adults in the KORA-study region (Augsburg, Germany)]. Gesundheitswesen 68(2), 110–115 (2006)CrossRef von Lengerke, T., Reitmeir, P., John, J.: [Direct medical costs of (severe) obesity: a bottom-up assessment of over- vs. normal-weight adults in the KORA-study region (Augsburg, Germany)]. Gesundheitswesen 68(2), 110–115 (2006)CrossRef
5.
go back to reference Stratmann, D., Wabitsch, M., Leidl, R.M.: Adipositas im Kindes und Jugendalter—Ansätze zur ökonomischen Analyse. Monatsschrift Kinderheilkunde 8, 786–792 (2000)CrossRef Stratmann, D., Wabitsch, M., Leidl, R.M.: Adipositas im Kindes und Jugendalter—Ansätze zur ökonomischen Analyse. Monatsschrift Kinderheilkunde 8, 786–792 (2000)CrossRef
6.
go back to reference Huang, T.T., Horlick, M.N.: Trends in childhood obesity research: a brief analysis of NIH-supported efforts. J. Law. Med. Ethics 35(1), 148–153 (2007)PubMedCrossRef Huang, T.T., Horlick, M.N.: Trends in childhood obesity research: a brief analysis of NIH-supported efforts. J. Law. Med. Ethics 35(1), 148–153 (2007)PubMedCrossRef
7.
go back to reference Lee, Y.S.: Consequences of childhood obesity. Ann. Acad. Med. Singapore 38(1), 75–77 (2009)PubMed Lee, Y.S.: Consequences of childhood obesity. Ann. Acad. Med. Singapore 38(1), 75–77 (2009)PubMed
8.
go back to reference John, J., Wenig, C.M., Wolfenstetter, S.B.: Recent economic findings on childhood obesity: cost-of-illness and cost-effectiveness of interventions. Curr. Opin. Clin. Nutr. Metab. Care 13(3), 305–313 (2010)PubMedCrossRef John, J., Wenig, C.M., Wolfenstetter, S.B.: Recent economic findings on childhood obesity: cost-of-illness and cost-effectiveness of interventions. Curr. Opin. Clin. Nutr. Metab. Care 13(3), 305–313 (2010)PubMedCrossRef
9.
go back to reference Johnson, E., McInnes, M., Shinogle, J.: What is the economic cost of overweight children? East. Econ. J. 32(1), 171–188 (2006) Johnson, E., McInnes, M., Shinogle, J.: What is the economic cost of overweight children? East. Econ. J. 32(1), 171–188 (2006)
10.
go back to reference Skinner, A.C., Mayer, M.L., Flower, K., Weinberger, M.: Health status and health care expenditures in a nationally representative sample: how do overweight and healthy-weight children compare? Pediatrics 121(2), e269–e277 (2008)PubMedCrossRef Skinner, A.C., Mayer, M.L., Flower, K., Weinberger, M.: Health status and health care expenditures in a nationally representative sample: how do overweight and healthy-weight children compare? Pediatrics 121(2), e269–e277 (2008)PubMedCrossRef
11.
go back to reference Estabrooks, P.A., Shetterly, S.: The prevalence and health care use of overweight children in an integrated health care system. Arch. Pediatr. Adolesc. Med. 161(3), 222–227 (2007)PubMedCrossRef Estabrooks, P.A., Shetterly, S.: The prevalence and health care use of overweight children in an integrated health care system. Arch. Pediatr. Adolesc. Med. 161(3), 222–227 (2007)PubMedCrossRef
12.
go back to reference Hampl, S.E., Carroll, C.A., Simon, S.D., Sharma, V.: Resource utilization and expenditures for overweight and obese children. Arch. Pediatr. Adolesc. Med. 161(1), 11–14 (2007)PubMedCrossRef Hampl, S.E., Carroll, C.A., Simon, S.D., Sharma, V.: Resource utilization and expenditures for overweight and obese children. Arch. Pediatr. Adolesc. Med. 161(1), 11–14 (2007)PubMedCrossRef
13.
go back to reference Buescher, P.A., Whitmire, J.T., Plescia, M.: Relationship between body mass index and medical care expenditures for North Carolina adolescents enrolled in Medicaid in 2004. Prev. Chronic Dis. 5(1), A04 (2008)PubMed Buescher, P.A., Whitmire, J.T., Plescia, M.: Relationship between body mass index and medical care expenditures for North Carolina adolescents enrolled in Medicaid in 2004. Prev. Chronic Dis. 5(1), A04 (2008)PubMed
14.
go back to reference Finkelstein, E.A., Trogdon, J.G.: Public health interventions for addressing childhood overweight: analysis of the business case. Am. J. Public Health 98(3), 411–415 (2008)PubMedCrossRef Finkelstein, E.A., Trogdon, J.G.: Public health interventions for addressing childhood overweight: analysis of the business case. Am. J. Public Health 98(3), 411–415 (2008)PubMedCrossRef
15.
go back to reference Monheit, A.C., Vistnes, J.P., Rogowski, J.A.: Overweight in adolescents: implications for health expenditures. Econ. Hum. Biol. 7(1), 55–63 (2009)PubMedCrossRef Monheit, A.C., Vistnes, J.P., Rogowski, J.A.: Overweight in adolescents: implications for health expenditures. Econ. Hum. Biol. 7(1), 55–63 (2009)PubMedCrossRef
16.
go back to reference Wolfenstetter, S.B.: Juvenile obesity and comorbidity type 2 diabetes mellitus (T2 DM) in Germany: development and cost-of-illness analysis. Gesundheitswesen 68(10), 600–612 (2006)PubMedCrossRef Wolfenstetter, S.B.: Juvenile obesity and comorbidity type 2 diabetes mellitus (T2 DM) in Germany: development and cost-of-illness analysis. Gesundheitswesen 68(10), 600–612 (2006)PubMedCrossRef
17.
go back to reference Welte, R., Feenstra, T., Jager, H., Leidl, R.: A decision chart for assessing and improving the transferability of economic evaluation results between countries. Pharmacoeconomics 22(13), 857–876 (2004)PubMedCrossRef Welte, R., Feenstra, T., Jager, H., Leidl, R.: A decision chart for assessing and improving the transferability of economic evaluation results between countries. Pharmacoeconomics 22(13), 857–876 (2004)PubMedCrossRef
18.
go back to reference Robert Koch-Institute: Public Use File KiGGS, Kinder- und Jugendgesundheitssurvey 2003–2006. Berlin (2008) Robert Koch-Institute: Public Use File KiGGS, Kinder- und Jugendgesundheitssurvey 2003–2006. Berlin (2008)
19.
go back to reference Kurth, B.M.: The German Health Interview and Examination Survey for Children and Adolescents (KiGGS): an overview of its planning, implementation and results taking into account aspects of quality management. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 50(5–6), 533–546 (2007)PubMed Kurth, B.M.: The German Health Interview and Examination Survey for Children and Adolescents (KiGGS): an overview of its planning, implementation and results taking into account aspects of quality management. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 50(5–6), 533–546 (2007)PubMed
20.
go back to reference Kurth, B.M., Kamtsiuris, P., Holling, H., Schlaud, M., Dolle, R., Ellert, U., Kahl, H., Knopf, H., Lange, M., Mensink, G.B., Neuhauser, H., Rosario, A.S., Scheidt-Nave, C., Schenk, L., Schlack, R., Stolzenberg, H., Thamm, M., Thierfelder, W., Wolf, U.: The challenge of comprehensively mapping children’s health in a nation-wide health survey: design of the German KiGGS-Study. BMC Public Health 8, 196 (2008)PubMedCrossRef Kurth, B.M., Kamtsiuris, P., Holling, H., Schlaud, M., Dolle, R., Ellert, U., Kahl, H., Knopf, H., Lange, M., Mensink, G.B., Neuhauser, H., Rosario, A.S., Scheidt-Nave, C., Schenk, L., Schlack, R., Stolzenberg, H., Thamm, M., Thierfelder, W., Wolf, U.: The challenge of comprehensively mapping children’s health in a nation-wide health survey: design of the German KiGGS-Study. BMC Public Health 8, 196 (2008)PubMedCrossRef
21.
go back to reference Hölling, H., Kamtsiuris, P., Lange, M., Thierfelder, W., Schlack, R., Tamm, M.: Der Kinder- und Jugendgesundheitssurvey (KiGGS): Studienmanagement und Durchführung der Feldarbeit. Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz 50, 557–566 (2007)PubMedCrossRef Hölling, H., Kamtsiuris, P., Lange, M., Thierfelder, W., Schlack, R., Tamm, M.: Der Kinder- und Jugendgesundheitssurvey (KiGGS): Studienmanagement und Durchführung der Feldarbeit. Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz 50, 557–566 (2007)PubMedCrossRef
22.
go back to reference Kamtsiuris, P., Lange, M., Schaffrath Rosario, A.: Der Kinder- und Jugendgesundheitssurvey (KiGGS): Stichprobendesign, Response und Nonresponse-Analyse. Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz 50, 547–556 (2007)PubMedCrossRef Kamtsiuris, P., Lange, M., Schaffrath Rosario, A.: Der Kinder- und Jugendgesundheitssurvey (KiGGS): Stichprobendesign, Response und Nonresponse-Analyse. Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz 50, 547–556 (2007)PubMedCrossRef
23.
go back to reference Kromeyer-Hauschild, K., Wabitsch, M., Kunze, D., Geller, F., Geiß, H., Hesse, V., von Hippel, A., Jaeger, U., Johnsen, D., Korte, W., Menner, K., Müller, J., Niemann-Pilatus, A., Remer, T., Schaefer, F., Wittchen, H., Zabransky, S., Zellner, K., Ziegler, K., Hebebrand, J.: Perzentile für den body-mass-index für das Kindes- und Jugendalter unter Heranziehung verschiedener deutscher Stichproben. Monatsschr Kinderheilkd 149, 807–881 (2001)CrossRef Kromeyer-Hauschild, K., Wabitsch, M., Kunze, D., Geller, F., Geiß, H., Hesse, V., von Hippel, A., Jaeger, U., Johnsen, D., Korte, W., Menner, K., Müller, J., Niemann-Pilatus, A., Remer, T., Schaefer, F., Wittchen, H., Zabransky, S., Zellner, K., Ziegler, K., Hebebrand, J.: Perzentile für den body-mass-index für das Kindes- und Jugendalter unter Heranziehung verschiedener deutscher Stichproben. Monatsschr Kinderheilkd 149, 807–881 (2001)CrossRef
24.
go back to reference Kleiser, C., Schaffrath Rosario, A., Mensink, G.B., Prinz-Langenohl, R., Kurth, B.M.: Potential determinants of obesity among children and adolescents in Germany: results from the cross-sectional KiGGS Study. BMC Public Health 9, 46 (2009)PubMedCrossRef Kleiser, C., Schaffrath Rosario, A., Mensink, G.B., Prinz-Langenohl, R., Kurth, B.M.: Potential determinants of obesity among children and adolescents in Germany: results from the cross-sectional KiGGS Study. BMC Public Health 9, 46 (2009)PubMedCrossRef
26.
go back to reference Winkler, J., Stolzenberg, H.: Der Sozialschichtindex im Bundes-Gesundheitssurvey. Gesundheitswesen 61(Sonderheft 2), 178–183 (1999) Winkler, J., Stolzenberg, H.: Der Sozialschichtindex im Bundes-Gesundheitssurvey. Gesundheitswesen 61(Sonderheft 2), 178–183 (1999)
27.
go back to reference Lange, M., Kamtsiuris, P., Lange, C., Schaffrath Rosario, A., Stolzenberg, H., Lampert, T.: Sociodemographic characteristics in the German Health Interview and Examination Survey for Children and Adolescents (KiGGS)––operationalisation and public health significance, taking as an example the assessment of general state of health. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 50(5–6), 578–589 (2007)PubMed Lange, M., Kamtsiuris, P., Lange, C., Schaffrath Rosario, A., Stolzenberg, H., Lampert, T.: Sociodemographic characteristics in the German Health Interview and Examination Survey for Children and Adolescents (KiGGS)––operationalisation and public health significance, taking as an example the assessment of general state of health. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 50(5–6), 578–589 (2007)PubMed
28.
go back to reference Ravens-Sieberer, U.: Der Kindl-R Fragebogen zur Erfassung der gesundheitsbezogenen Lebensqualität bei Kindern und Jugendlichen -Revidierte Form. In: Schumacher, J., Klaiberg, A., Brähler, E. (eds.) Diagnostische Verfahren zu Lebensqualität und Wohlbefinden, pp. 184–188. Hogrefe, Göttingen (2003) Ravens-Sieberer, U.: Der Kindl-R Fragebogen zur Erfassung der gesundheitsbezogenen Lebensqualität bei Kindern und Jugendlichen -Revidierte Form. In: Schumacher, J., Klaiberg, A., Brähler, E. (eds.) Diagnostische Verfahren zu Lebensqualität und Wohlbefinden, pp. 184–188. Hogrefe, Göttingen (2003)
29.
go back to reference Ravens-Sieberer, U., Bullinger, M.: Assessing health related quality of life in chronically ill children with the german KINDL: first psychomertric and content analytical results. Qual. Life Res. 7(5), 399–407 (1998)PubMedCrossRef Ravens-Sieberer, U., Bullinger, M.: Assessing health related quality of life in chronically ill children with the german KINDL: first psychomertric and content analytical results. Qual. Life Res. 7(5), 399–407 (1998)PubMedCrossRef
30.
go back to reference Krauth, C., Hessel, F., Hansmeier, T., Wasem, J., Seitz, R., Schweikert, B.: Empirical standard costs for health economic evaluation in Germany—a proposal by the working group methods in health economic evaluation. Gesundheitswesen 67(10), 736–746 (2005)PubMedCrossRef Krauth, C., Hessel, F., Hansmeier, T., Wasem, J., Seitz, R., Schweikert, B.: Empirical standard costs for health economic evaluation in Germany—a proposal by the working group methods in health economic evaluation. Gesundheitswesen 67(10), 736–746 (2005)PubMedCrossRef
35.
go back to reference Statistisches Bundesamt Deutschland: Statistisches Jahrbuch für die Bundesrepublik Deutschland 2008 [Statistical yearbook 2008]. In: Bundesamt, S. (ed.). Wiesbaden (2008) Statistisches Bundesamt Deutschland: Statistisches Jahrbuch für die Bundesrepublik Deutschland 2008 [Statistical yearbook 2008]. In: Bundesamt, S. (ed.). Wiesbaden (2008)
36.
go back to reference Knopf, H.: Arzneimittelanwendung bei Kindern und Jugendlichen. Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz 50, 863–870 (2007)PubMedCrossRef Knopf, H.: Arzneimittelanwendung bei Kindern und Jugendlichen. Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz 50, 863–870 (2007)PubMedCrossRef
37.
go back to reference Kamtsiuris, P., Bergmann, E., Rattay, P., Schlaud, M.: Inanspruchnahme medizinischer Leistungen–Ergebnisse des Kinder- und Jugendgesundheitssurveys (KiGGS). Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz 50, 836–850 (2007)PubMedCrossRef Kamtsiuris, P., Bergmann, E., Rattay, P., Schlaud, M.: Inanspruchnahme medizinischer Leistungen–Ergebnisse des Kinder- und Jugendgesundheitssurveys (KiGGS). Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz 50, 836–850 (2007)PubMedCrossRef
38.
go back to reference Barber, J., Thompson, S.: Multiple regression of cost data: use of generalised linear models. J. Health Serv. Res. Policy 9(4), 197–204 (2004)PubMedCrossRef Barber, J., Thompson, S.: Multiple regression of cost data: use of generalised linear models. J. Health Serv. Res. Policy 9(4), 197–204 (2004)PubMedCrossRef
39.
go back to reference Manning, W.G., Basu, A., Mullahy, J.: Generalized modeling approaches to risk adjustment of skewed outcomes data. J. Health Econ. 24(3), 465–488 (2005)PubMedCrossRef Manning, W.G., Basu, A., Mullahy, J.: Generalized modeling approaches to risk adjustment of skewed outcomes data. J. Health Econ. 24(3), 465–488 (2005)PubMedCrossRef
40.
go back to reference An, A.: Performing logistic regression on survey data with the new surveylogistic procedure. In: SAS global forum proceedings (2002) An, A.: Performing logistic regression on survey data with the new surveylogistic procedure. In: SAS global forum proceedings (2002)
41.
go back to reference An, A., Watts, D.: New SAS procedures for analysis of sample survey data. In SAS global forum proceedings (2000) An, A., Watts, D.: New SAS procedures for analysis of sample survey data. In SAS global forum proceedings (2000)
42.
go back to reference Kilian, R., Matschinger, H., Loeffler, W., Roick, C., Angermeyer, M.C.: A comparison of methods to handle skew distributed cost variables in the analysis of the resource consumption in schizophrenia treatment. J. Mental Health Policy Econ. 5(1), 21–31 (2002) Kilian, R., Matschinger, H., Loeffler, W., Roick, C., Angermeyer, M.C.: A comparison of methods to handle skew distributed cost variables in the analysis of the resource consumption in schizophrenia treatment. J. Mental Health Policy Econ. 5(1), 21–31 (2002)
43.
go back to reference Hodgson, T.A., Meiners, M.R.: Cost-of-illness methodology: a guide to current practices and procedures. Milbank Mem. Fund Q. Health Soc. 60(3), 429–462 (1982)PubMedCrossRef Hodgson, T.A., Meiners, M.R.: Cost-of-illness methodology: a guide to current practices and procedures. Milbank Mem. Fund Q. Health Soc. 60(3), 429–462 (1982)PubMedCrossRef
44.
go back to reference Akobundu, E., Ju, J., Blatt, L., Mullins, C.D.: Cost-of-illness studies: a review of current methods. Pharmacoeconomics 24(9), 869–890 (2006)PubMedCrossRef Akobundu, E., Ju, J., Blatt, L., Mullins, C.D.: Cost-of-illness studies: a review of current methods. Pharmacoeconomics 24(9), 869–890 (2006)PubMedCrossRef
45.
go back to reference Bloom, B.S., Bruno, D.J., Maman, D.Y., Jayadevappa, R.: Usefulness of US cost-of-illness studies in healthcare decision making. Pharmacoeconomics 19(2), 207–213 (2001)PubMedCrossRef Bloom, B.S., Bruno, D.J., Maman, D.Y., Jayadevappa, R.: Usefulness of US cost-of-illness studies in healthcare decision making. Pharmacoeconomics 19(2), 207–213 (2001)PubMedCrossRef
46.
go back to reference Polder, J.J., Meerding, W.J., Bonneux, L., van der Maas, P.J.: A cross-national perspective on cost of illness: a comparison of studies from The Netherlands, Australia, Canada, Germany, United Kingdom, and Sweden. Eur. J. Health Econ. 6(3), 223–232 (2005)PubMedCrossRef Polder, J.J., Meerding, W.J., Bonneux, L., van der Maas, P.J.: A cross-national perspective on cost of illness: a comparison of studies from The Netherlands, Australia, Canada, Germany, United Kingdom, and Sweden. Eur. J. Health Econ. 6(3), 223–232 (2005)PubMedCrossRef
47.
go back to reference Clabaugh, G., Ward, M.M.: Cost-of-illness studies in the United States: a systematic review of methodologies used for direct cost. Value Health 11(1), 13–21 (2008)PubMedCrossRef Clabaugh, G., Ward, M.M.: Cost-of-illness studies in the United States: a systematic review of methodologies used for direct cost. Value Health 11(1), 13–21 (2008)PubMedCrossRef
48.
go back to reference Janssen, I., Lam, M., Katzmarzyk, P.T.: Influence of overweight and obesity on physician costs in adolescents and adults in Ontario, Canada. Obes. Rev. 10(1), 51–57 (2009)PubMedCrossRef Janssen, I., Lam, M., Katzmarzyk, P.T.: Influence of overweight and obesity on physician costs in adolescents and adults in Ontario, Canada. Obes. Rev. 10(1), 51–57 (2009)PubMedCrossRef
49.
go back to reference Janicke, D.M., Harman, J.S., Jamoom, E.W., Simon, S.L., Zhang, J., Dumont-Driscoll, M.: The relationship among child weight status, psychosocial functioning, and pediatric health care expenditures in a medicaid population. J. Pediatr. Psychol. 35(8), 883–891 (2010)PubMedCrossRef Janicke, D.M., Harman, J.S., Jamoom, E.W., Simon, S.L., Zhang, J., Dumont-Driscoll, M.: The relationship among child weight status, psychosocial functioning, and pediatric health care expenditures in a medicaid population. J. Pediatr. Psychol. 35(8), 883–891 (2010)PubMedCrossRef
50.
go back to reference Evans, C., Crawford, B.: Patient self-reports in pharmacoeconomic studies. Their use and impact on study validity. Pharmacoeconomics 15(3), 241–256 (1999)PubMedCrossRef Evans, C., Crawford, B.: Patient self-reports in pharmacoeconomic studies. Their use and impact on study validity. Pharmacoeconomics 15(3), 241–256 (1999)PubMedCrossRef
51.
go back to reference Woolford, S., Gebremariam, A., Clark, S., Davis, M.: Incremental hospital charges associated with obesity as a secondary diagnosis in children. Obesity (Silver Spring) 15(7), 1895–1901 (2007)CrossRef Woolford, S., Gebremariam, A., Clark, S., Davis, M.: Incremental hospital charges associated with obesity as a secondary diagnosis in children. Obesity (Silver Spring) 15(7), 1895–1901 (2007)CrossRef
52.
go back to reference Böhler, T., Dziuk, M.: Adiposity in children and adolescents—the relevance of prevention and rehabilitation. Gesundheitswesen 71(1), 41–47 (2009) (quiz 48–51) Böhler, T., Dziuk, M.: Adiposity in children and adolescents—the relevance of prevention and rehabilitation. Gesundheitswesen 71(1), 41–47 (2009) (quiz 48–51)
53.
go back to reference Burkhauser, R.V., Cawley, J.: Beyond BMI: the value of more accurate measures of fatness and obesity in social science research. J. Health Econ. 27(2), 519–529 (2008)PubMedCrossRef Burkhauser, R.V., Cawley, J.: Beyond BMI: the value of more accurate measures of fatness and obesity in social science research. J. Health Econ. 27(2), 519–529 (2008)PubMedCrossRef
54.
go back to reference Eto, C., Komiya, S., Nakao, T., Kikkawa, K.: Validity of the body mass index and fat mass index as an indicator of obesity in children aged 3–5 year. J. Physiol. Anthropol. Appl. Human Sci. 23(1), 25–30 (2004)PubMedCrossRef Eto, C., Komiya, S., Nakao, T., Kikkawa, K.: Validity of the body mass index and fat mass index as an indicator of obesity in children aged 3–5 year. J. Physiol. Anthropol. Appl. Human Sci. 23(1), 25–30 (2004)PubMedCrossRef
55.
go back to reference Dencker, M., Thorsson, O., Linden, C., Wollmer, P., Andersen, L.B., Karlsson, M.K.: BMI and objectively measured body fat and body fat distribution in prepubertal children. Clin. Physiol. Funct. Imaging 27(1), 12–16 (2007)PubMedCrossRef Dencker, M., Thorsson, O., Linden, C., Wollmer, P., Andersen, L.B., Karlsson, M.K.: BMI and objectively measured body fat and body fat distribution in prepubertal children. Clin. Physiol. Funct. Imaging 27(1), 12–16 (2007)PubMedCrossRef
56.
go back to reference Tarricone, R.: Cost-of-illness analysis. What room in health economics? Health Policy 77(1), 51–63 (2006)PubMedCrossRef Tarricone, R.: Cost-of-illness analysis. What room in health economics? Health Policy 77(1), 51–63 (2006)PubMedCrossRef
57.
go back to reference Magarey, A.M., Daniels, L.A., Boulton, T.J., Cockington, R.A.: Predicting obesity in early adulthood from childhood and parental obesity. Int. J. Obes. Relat. Metab. Disord. 27(4), 505–513 (2003)PubMedCrossRef Magarey, A.M., Daniels, L.A., Boulton, T.J., Cockington, R.A.: Predicting obesity in early adulthood from childhood and parental obesity. Int. J. Obes. Relat. Metab. Disord. 27(4), 505–513 (2003)PubMedCrossRef
58.
go back to reference Sturm, R.: The effects of obesity, smoking, and drinking on medical problems and costs. Health Aff. 21(2), 245–253 (2002)CrossRef Sturm, R.: The effects of obesity, smoking, and drinking on medical problems and costs. Health Aff. 21(2), 245–253 (2002)CrossRef
59.
go back to reference Friedlander, S.L., Larkin, E.K., Rosen, C.L., Palermo, T.M., Redline, S.: Decreased quality of life associated with obesity in school-aged children. Arch. Pediatr. Adolesc. Med. 157(12), 1206–1211 (2003)PubMedCrossRef Friedlander, S.L., Larkin, E.K., Rosen, C.L., Palermo, T.M., Redline, S.: Decreased quality of life associated with obesity in school-aged children. Arch. Pediatr. Adolesc. Med. 157(12), 1206–1211 (2003)PubMedCrossRef
60.
go back to reference Schwimmer, J.B., Burwinkle, T.M., Varni, J.W.: Health-related quality of life of severely obese children and adolescents. JAMA 289(14), 1813–1819 (2003)PubMedCrossRef Schwimmer, J.B., Burwinkle, T.M., Varni, J.W.: Health-related quality of life of severely obese children and adolescents. JAMA 289(14), 1813–1819 (2003)PubMedCrossRef
61.
go back to reference Swallen, K.C., Reither, E.N., Haas, S.A., Meier, A.M.: Overweight, obesity, and health-related quality of life among adolescents: the national longitudinal study of adolescent health. Pediatrics 115(2), 340–347 (2005)PubMedCrossRef Swallen, K.C., Reither, E.N., Haas, S.A., Meier, A.M.: Overweight, obesity, and health-related quality of life among adolescents: the national longitudinal study of adolescent health. Pediatrics 115(2), 340–347 (2005)PubMedCrossRef
62.
go back to reference Zhang, L., Fos, P.J., Johnson, W.D., Kamali, V., Cox, R.G., Zuniga, M.A., Kittle, T.: Body mass index and health related quality of life in elementary school children: a pilot study. Health Qual. Life Outcomes 6, 77 (2008) Zhang, L., Fos, P.J., Johnson, W.D., Kamali, V., Cox, R.G., Zuniga, M.A., Kittle, T.: Body mass index and health related quality of life in elementary school children: a pilot study. Health Qual. Life Outcomes 6, 77 (2008)
63.
go back to reference Ravens-Sieberer, U., Ellert, U., Erhart, M.: [Health-related quality of life of children and adolescents in Germany. Norm data from the German health interview and examination survey (KiGGS)]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 50(5–6), 810–818 (2007)PubMed Ravens-Sieberer, U., Ellert, U., Erhart, M.: [Health-related quality of life of children and adolescents in Germany. Norm data from the German health interview and examination survey (KiGGS)]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 50(5–6), 810–818 (2007)PubMed
64.
go back to reference Wewetzer, C.: Current aspects in diagnostics and therapy of Anorexia nervosa in children and adolescents. MMW Fortschr Med 150(44), 29–30, 32 (2008) Wewetzer, C.: Current aspects in diagnostics and therapy of Anorexia nervosa in children and adolescents. MMW Fortschr Med 150(44), 29–30, 32 (2008)
65.
go back to reference Trasande, L., Chatterjee, S.: The impact of obesity on health service utilization and costs in childhood. Obesity (Silver Spring) 17(9), 1749–1754 (2009)CrossRef Trasande, L., Chatterjee, S.: The impact of obesity on health service utilization and costs in childhood. Obesity (Silver Spring) 17(9), 1749–1754 (2009)CrossRef
66.
go back to reference Duan, N.: Smearing estimate: a nonparametric retransformation method. JASA 78, 605–610 (1983) Duan, N.: Smearing estimate: a nonparametric retransformation method. JASA 78, 605–610 (1983)
67.
go back to reference Manning, W.G.; Mullahy, J.: Estimating log models: to transform or not to transform? J. Health Econ. 20(4), 461–494 (2001) Manning, W.G.; Mullahy, J.: Estimating log models: to transform or not to transform? J. Health Econ. 20(4), 461–494 (2001)
Metadata
Title
The impact of BMI on direct costs in Children and Adolescents: empirical findings for the German Healthcare System based on the KiGGS-study
Author
Christina M. Wenig
Publication date
01-02-2012
Publisher
Springer-Verlag
Published in
The European Journal of Health Economics / Issue 1/2012
Print ISSN: 1618-7598
Electronic ISSN: 1618-7601
DOI
https://doi.org/10.1007/s10198-010-0278-7

Other articles of this Issue 1/2012

The European Journal of Health Economics 1/2012 Go to the issue