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The Cost of Obesity: National Cost Estimates of Obese versus Non-Obese Patients for Non-Bariatric Inpatient Operative Procedures in the USA
Rodney J Mason*1, Jolene R Moroney*2, Thomas V Berne1
1University of Southern California, Los Angeles, CA;2University of California, Los Angeles, Los Angeles, CA

OBJECTIVE(S):To evaluate the economic impact of obesity on hospital costs associated with non-bariatric, non-obstetrical surgical procedures.
METHODS: National cost estimates were calculated from the Healthcare Cost and Utilization Project (HCUP) Nationwide Inpatient Sample (NIS) database, 2005-2010 for the country’s highest volume non-bariatric non-obstetric procedures. NIS approximates a 20-percent stratified sample of U.S. hospitals. Obesity was determined and identified from the HCUP-NIS severity datafile comorbidity element for obesity. Costs for obese patients were compared to non-obese patients. To control for outcome reporting bias for each procedure, each obese patient was matched to a non-obese patient using age, sex, race and all 28 co-morbid defined elements in the NIS database.
RESULTS:Of 2,307,382 procedures, 225,450 (10%) patients were categorized obese and able to be matched 1-to-1 to a non-obese patient for the adjusted analysis. Total hospital costs were significantly higher (p<0.0001) in obese patients for all selected procedures (Figure). Costs/day were significantly higher in obese patients for total knee replacement, cholecystectomy, hysterectomy, laparoscopic appendectomy and colectomy (Table).
CONCLUSIONS:Obese patients incur significantly higher total and daily hospital costs than comparative non-obese patients, which translates to a conservative estimated additional annual national cost of $192,135,852.00 for these selected procedures.
Mean Differences: Costs/day ($)
ProcedureTotal Number
2005-2010
Matched Cohort
(number)
Costs/day ($)
Mean Differences (95%CI)
Obese minus Non-Obese
p value
Total Knee Replacement504,253153,892$90.00 ($62 to $118)<0.0001
Cholecystectomy347,53773,200$85.00 ($47 to $124)<0.0001
Hysterectomy334,99254,788$209.00 ($176 to $241)<0.0001
Cervical /Lumbar Spinal Fusion250,18840,092$56.00 (-$82 to $194)0.426
Total Hip Replacement232,08445,662$44.00 ($-12 to $101)0.121
Coronary Artery Bypass200,48043,804$36.00 ($13 to $86)0.151
Laparoscopic Appendectomy168,76614,828$121.00 ($9 to $232)0.034
Colon Resection142,24813,972$86.00 ($36 to $137)0.0009
Open Appendectomy126,83410,662$63.00 (-$23 to $150 )0.153


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