Abstract
Objective
In many countries, pediatricians offer skilled secondary care for children with conditions
more challenging than can readily be managed in the primary care sector, but the extent
to which this sector engages with the detection and management of obesity remains
largely unexplored. This study aimed to audit the prevalence, diagnosis, patient,
and consultation characteristics of obesity in Australian pediatric practices.
Methods
This was a national prospective patient audit in Australia. During the course of 2
weeks, members of the Australian Paediatric Research Network prospectively recorded
consecutive outpatient consultations by using a brief standardized data collection
form. Measures included height, weight, demographics, child and parent health ratings,
diagnoses, referrals, investigations, and consultation characteristics. We compared
the prevalence of pediatrician-diagnosed and measured obesity (body mass index ≥95th
percentile) and top-ranked diagnoses, patient, and consultation characteristics in
(a) obese and nonobese children, and (b) obese children with and without a diagnosis.
Results
A total of 198 pediatricians recorded 5466 consultations with 2–17 year olds, with
body mass index z-scores calculated for 3436 (62.9%). Of the 12.6% obese children,
only one-third received an “overweight/obese” diagnosis. Obese children diagnosed
as overweight/obese were heavier, older, and in poorer health than those not diagnosed
and incurred more Medicare (government-funded health system) cost and referrals.
Conclusions
Obesity is infrequently clinically diagnosed by Australian pediatricians and measurement
practices vary widely. Further research could focus on supporting and normalizing
clinical obesity activities from which pediatricians and parents could see clear benefits.
Keywords
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Article info
Publication history
Accepted:
December 18,
2012
Received:
August 15,
2012
Footnotes
The authors have no conflicts of interest to disclose.
Identification
Copyright
© 2013 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.
