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Demand for health services and drug prescriptions among overweight or obese preschool children
  1. Maira Alejandra Ortiz-Pinto1,2,3,
  2. Honorato Ortiz-Marrón4,
  3. María D Esteban-Vasallo5,
  4. Agueda Quadrado-Mercadal6,
  5. Dayami Casanova-Pardomo7,
  6. Marta González-Alcón8,
  7. María Ordobás-Gavin4,
  8. Iñaki Galán1,2
  1. 1 Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, Spain
  2. 2 Departmento de Medicina Preventiva y Salud Pública, Universidad Autonoma de Madrid/IdiPAZ, Madrid, Spain
  3. 3 Universidad del Norte, Barranquilla, Colombia
  4. 4 Servicio de Epidemiología, Consejería de Sanidad, Madrid, Spain
  5. 5 Servicio de Informes de Salud y Estudios, Consejería de Sanidad, Madrid, Spain
  6. 6 Centro de Salud Navas del Rey, Consejería de Sanidad, Madrid, Spain
  7. 7 Centro de Salud Cubas de la Sagra, Consejería de Sanidad, Madrid, Spain
  8. 8 Centro de Salud Lavapies, Consejería de Sanidad, Madrid, Spain
  1. Correspondence to Dr Iñaki Galán, Instituto de Salud Carlos III, Madrid 28029, Spain; igalan{at}


Objectives To evaluate the association between excess weight and the demand of health services in preschool children compared with healthy weight.

Methods The data come from the Longitudinal Study of Childhood Obesity cohort (1884 4-year-old children, residing in the Madrid region, Spain) who provided information through telephone questionnaire, physical examination and electronic medical records. We defined overweight, general and abdominal obesity based on body mass index, waist circumference and waist-to-height ratio. Using mixed models of multivariable negative binomial regression we calculated the incidence rate ratio (IRR) regarding primary care (PC) doctor visits, drug prescriptions and hospital admissions by weight status at the end of the 2-year follow-up.

Results Childhood general obesity was associated with a higher demand for PC services related to psychological problems (IRR=1.53; 95% CI 1.02 to 2.28) and childhood abdominal obesity, according to waist-to-height ratio, was related to more frequent problems of the musculoskeletal system (IRR=1.27; 95% CI 1.00 to 1.62). Drugs were prescribed more frequently to children falling under all three definitions of excess weight, compared with healthy weight children. No differences in the number of hospital admissions were observed.

Conclusions The demand of health services related to early childhood obesity was small. Nevertheless, obesity was associated with a slightly greater demand for drug prescriptions and for PC doctor visits related to psychological and musculoskeletal problems.

  • child obesity
  • waist circumference
  • body mass index
  • healthcare
  • drug prescriptions

Statistics from


  • Contributors MAO-P and IG, conceptualised and designed the study, drafted the initial manuscript, and reviewed and revised the manuscript. MAO-P and IG, designed the data collection instruments, collected data, carried out the initial analyses and MAO-P, HO-M, ME-V and IG, reviewed and revised the manuscript. HO-M, ME-V, AQ-M, DC-P, MG-A, MO-G, collected data, and critically reviewed the manuscript for important intellectual content. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval The study protocol was approved by the Ethics Committee of the Ramón y Cajal Hospital in Madrid, approval number 242 and register number 44/10.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement There are no data in this work. Data are available upon reasonable request. Data may be obtained from a third party and are not publicly available. No data are available. All data relevant to the study are included in the article or uploaded as supplementary information.

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