Poster - Children's Hospitals Respond to Obesity
Presented at Pediatric Hospital Medicine, Lake Buena Vista, FL, July 2014
The National Center for Health Statistics estimates 17% of children and adolescents ages 2-19 years are obese (BMI > 95%tile). That's 12.5 million obese children and adolescents -- a prevalence rate that has tripled since 1980. Obesity increases a child's risk for an array of medical problems including cardiovascular disease, diabetes, bone and joint problems, sleep apnea and depression, necessitating an increased awareness in the identification and treatment of obesity and its consequences for those practicing hospital medicine.
The Children's Hospital Association fielded a survey of its U.S. membership to better understand the children's hospitals' response in identification and treatment of childhood obesity. An on-line survey was sent to 218 member institutions with 118 responses (54%). The survey was sent to pre-identified medical directors, or to hospital administrators with instruction to forward to the most appropriate faculty or administrator for completion. Multiple attempts were made to reach non-respondents via email and phone calls.
61% of respondents report childhood obesity was identified as an issue on their community health needs assessment and 59% report offering comprehensive, multidisciplinary weight management services. However only 51 respondents (42%) report their hospital has a policy for identifying patients who are overweight and obese in all settings (inpatient, outpatient and primary care) while an additional 15% have such policy for select settings. In 42% of institutions there is no policy for identification, or the respondent was unaware of a policy. Among hospitals with a weight management program, 70% report their hospitals electronic health record prompts input of height and weight to calculate BMI, while 30% report the record has no such prompt or they are unaware of a prompt.
Identification and treatment of obesity should be a standard of care in all inpatient and outpatient settings at children's hospitals. Beyond the need to address the patient's weight for treatment, it important to be aware of for the physical and emotional safety of patients. Less than half of respondents to a national survey report having a policy in place to identify patients who are obese, a first step in ensuring they get appropriate care. Pediatric hospitalists can advocate for change and the adoption of these important policies in their institutions.