Obesity and Incremental Hospital Charges among Patients with and without Diabetes in the United States

Objective: The purpose of this study was to estimate the association between obesity and diabetes among inpatients in the United States as well as to investigate the incremental hospital charges attributable to obesity or morbid obesity. Methods: We analyzed the Nationwide Inpatient Sample 2005, a nationally representative probability sample that includes nearly 8 million inpatient records from US community hospitals. Results: During the past decade, the obesity among inpatients has steeply increased. In 2005, nearly 1.87 million hospitalizations were made by obese or morbidly obese patients. Both patients with type 1 and type 2 diabetes were considerably more likely to be obese or morbidly obese compared with inpatients without diabetes (P < 0.01). The proportions of hospitalizations with obese or morbidly obese conditions were 4.5% among patients without diabetes, 6.5% among patients with type 1, and 12.2% among patients with type 2 diabetes. The hospital charges for obese and morbidly obese patients were 6.1% (P < 0.01) and 18.7% (P < 0.01) higher than that of the nonobese patients when diabetes status, sex, age, race, hospital admission type, and length of hospital stays were the same. Conclusions: Following a parallel rise in obesity among the general population, hospital admissions of obese and morbidly obese inpatients are continuously increasing. Morbidly obese patients consumed substantially more hospital resources regardless of the presence or type of diabetes. Under the current price-per-case reimbursement system, additional hospital resource use by this growing number of morbidly obese inpatients could be a burden to hospital financial systems.