Abstract
Objective
To examine obesity diagnosis, obesity-related counseling, and laboratory testing rates
among obese pediatric patients seen in US preventive outpatient visits and to determine
patient, provider, and practice-level factors that are associated with obesity diagnosis.
Methods
By using 2005–2007 National Ambulatory Medical Care Survey and National Hospital Ambulatory
Medical Care Survey data, outpatient preventive visits made by obese (body mass index
≥95%) 2- to 18-year-old patients were examined for frequencies of obesity diagnosis,
diet, exercise, or weight reduction counseling, and glucose or cholesterol testing.
Multivariable logistic regression was used to examine whether patient-level (gender,
age, race/ethnicity, insurance type) and provider/practice-level (geographic region,
provider specialty, and practice setting) factors were associated with physician obesity
diagnosis.
Results
Physicians documented an obesity diagnosis in 18% (95% confidence interval, 13–23)
of visits made by 2- to 18-year-old patients with a body mass index ≥95%. Documentation
of an obesity diagnosis was more likely for non-white patients (odds ratio 2.87; 95%
confidence interval, 1.3–6.3). Physicians were more likely to provide obesity-related
counseling (51% of visits) than to conduct laboratory testing (10% of visits) for
obese pediatric patients.
Conclusion
Rates of documented obesity diagnosis, obesity-related counseling, and laboratory
testing for comorbid conditions among obese pediatric patients seen in US outpatient
preventive visits are suboptimal. Efforts should target enhanced obesity diagnosis
as a first step toward improving pediatric obesity management.
Keywords
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Article Info
Publication History
Accepted:
September 17,
2010
Received:
January 21,
2010
Footnotes
Funding: none
Conflicts of Interest: none
Identification
Copyright
© 2010 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.
