Underdiagnosis of pediatric obesity during outpatient preventive care visits

Anisha I. Patel, Kristine A. Madsen, Judith H. Maselli, Michael D. Cabana, Randall S. Stafford, Adam L. Hersh

Research output: Contribution to journalArticle

57 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)405-409
Number of pages5
JournalAcademic Pediatrics
Volume10
Issue number6
DOIs
StatePublished - Nov 1 2010
Externally publishedYes

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Keywords

  • Children
  • Diagnosis
  • Obesity
  • Screening
  • Treatment

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Patel, A. I., Madsen, K. A., Maselli, J. H., Cabana, M. D., Stafford, R. S., & Hersh, A. L. (2010). Underdiagnosis of pediatric obesity during outpatient preventive care visits. Academic Pediatrics, 10(6), 405-409. https://doi.org/10.1016/j.acap.2010.09.004