Obesity in the Trauma Patient Delays Hospital Discharge and Increases Treatment Cost

Document Type

Conference Presentation

Department

Health, Exercise, and Sport Sciences Department

Conference Title

American College of Sports Medicine - Medicine & Science in Sports & Exercise conference

Organization

American College of Sports Medicine

Location

Minneapolis, MN

Date of Presentation

6-1-2018

Journal Publication

Medicine & Science in Sports & Exercise

ISSN

0195-9131

DOI

10.1249/01.mss.0000537102.86007.ad

Volume

50

Issue

5S

First Page

611

Last Page

612

Abstract

In the United States, more than one third of all adults are obese, classified by a BMI ≥ 30 kg/m2. Direct medical costs for these individuals account for approximately 6% of national health expenditure. Several mechanisms have been proposed, but most consistently, obesity has been shown to complicate treatment and inflate resource utilization. Another possible explanation is obesity’s role in prolonging recovery. Currently, information regarding the relationship between obesity and the duration of care is limited. PURPOSE: To examine the effect of obesity on hospital discharge and consequent treatment cost. METHODS: Our study involved 1,201 patients admitted to a Midwestern hospital who had complete demographic, anthropometric, and treatment data. Independent variables were age, sex, anthropometric indices, and five measurements of injury severity. Dependent variables were hospital length of stay (number of days) and total patient billing (dollars). Independent-samples t tests assessed differences between obese and non-obese patients, a negative binomial regression evaluated hospital length of stay, and a multiple linear regression tested logged cost data. RESULTS: Across the sample, average age was 55.1 ± 20.3 and 67.5% of patients were male. Average BMI was 28.4 ± 6.6 and 14.4% of patients were obese. Mean injury severity score was 16.3 ± 10.6 and average length of stay was 7.7 ± 9.0 days. Independent-samples t tests found obese patients to have 19.4% longer hospital stays (1.5 days; p=0.061) and 31.4% greater hospital bills (p=0.015) than non-obese patients. With confounding variables held constant, the negative binomial regression found obesity to predict a 17.1% longer hospital stay (1.3 days; p=0.007). While the multiple linear regression showed a non-significant increase for the effect of BMI on logged patient charges (p=0.111), classification of obesity on logged patient charges supported a trend for increase in patient cost (p=0.078). CONCLUSIONS: Obesity in the hospitalized patient associated with a significantly longer duration of care and a trend for increased total expenditure. Exercise may function as a preventive strategy to avert the temporal and financial ramifications of obesity.

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