| Background. Obesity is a growing concern impacting aspects of health care including a hospital's total charges. The objectives of this study are to compare the aspects, which could influence hospitals' total charges for the obese population and compare demographic information between the obese and non-obese populations using the Healthcare Cost and Utilization Project (HCUP) Nationwide Inpatient Sample (NIS) years 2001--2003.;Methods. The Clinical Classified Software (CCS) Multiple Diagnosis Tool was used to separate the obese records using the Level 3 Label of 'Obesity'. Two sample t-tests were run for average charges, average ages, lengths of stay, number of diagnoses, and number of procedures for an obese person vs. the non-obese person. Comparisons for patient, hospital demographics and top diseases/conditions based on ICD-9-CM codes were done for the obese vs. the non-obese population. Factor analysis was performed in SPSS. Multiple regression with maximum R2 in SAS 8.2 was used. Monte Carlo simulations were then run for the factors most prominent as a result of the multiple regression models.;Results. Totals of 176,549 obese records and 4,480,339 non-obese records were extracted for years 2001, 2002, and 2003 for use in this study. The obese population had higher average total charges (p<0.05), younger average ages for a hospital stay and death (p<0.05), longer lengths of stay (p<0.05), more diagnoses and procedures on average (p<0.05) than the non-obese population. Several models were the result of multiple regression based on total charges. The Monte Carlo simulations for normal, uniform, and Poisson resulted in some very accurate simulations for specific data element while others were very inaccurate.;Conclusion. Overall, the obese population has higher total charges on average for all hospital stays and some specific diseases/conditions. Total charges have risen for the obese population from 2001--2003. The obese also have a shorter life expectancy if death occurs but have a lower overall death rate. While different models have been developed to determine what factors influence obesity total charges, there are probably other factors which are not included in the NIS. Factors influencing total charges vary depending on the total charge. |
