Differences in Frequency of Visits to Pediatric Primary Care Practices and Emergency Departments by Body Mass Index |
| |
| Affiliation: | 1. Department of Emergency Medicine, Yale University School of Medicine (O Kovalerchik and ML Langhan), New Haven, Conn;2. Department of Pediatrics, Section of Emergency Medicine, Yale University School of Medicine (E Powers and ML Langhan), New Haven, Conn;3. Department of Pediatrics, Section of General Pediatrics, Yale University School of Medicine (E Powers and M Sharifi), New Haven, Conn;4. Yale University School of Nursing (ML Holland), Orange, Conn;1. Center for Injury Research and Policy, The Research Institute at Nationwide Children''s Hospital (E Auh, S Kistamgari, J Yang, and GA Smith), Columbus, Ohio;2. Geisel School of Medicine, Dartmouth College (E Auh), Hanover, NH;3. Department of Pediatrics, The Ohio State University College of Medicine (J Yang and GA Smith), Columbus, Ohio;4. Child Injury Prevention Alliance (GA Smith), Columbus, Ohio;1. Harvard Medical School (R Reardon, L Beyer, K Carpenter, M Irwin, K Kester, J Laird, C Moore, and P Shah), Boston, Mass;2. Boston Children''s Hospital (R Conrad), Boston, Mass;1. Department of Pediatrics, David Geffen School of Medicine at UCLA, Mattel Children''s Hospital, Los Angeles, Calif (ES Barnert);2. Department of Psychiatry, David Geffen School of Medicine at UCLA, Los Angeles, Calif (SM Godoy);3. UC Berkeley, School of Social Welfare, Berkeley, Calif (I Hammond);4. Department of Psychiatry, David Geffen School of Medicine at UCLA, Los Angeles, Calif (MA Kelly);5. Department of Pediatrics, David Geffen School of Medicine at UCLA and Mattel Children''s Hospital, Los Angeles, Calif (LR Thompson);6. Stanford University, Stanford School of Medicine, Stanford, Calif (S Mondal);7. Department of Psychiatry, David Geffen School of Medicine at UCLA, UCLA Semel Neuropsychiatric Institute, Los Angeles, Calif (EP Bath);1. Department of Pediatrics, University of Chicago Pritzker School of Medicine (HB Fromme), Chicago, Ill;2. Department of Pediatrics, Virginia Commonwealth University School of Medicine (MS Ryan), Richmond, Va;3. Department of Pediatrics, The Larner College of Medicine at the University of Vermont (K Gray), Burlington, Vt;4. Department of Pediatrics, University of Florida College of Medicine (E Black and N Paradise Black), Gainesville, Fla;5. Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons (S Paik), New York, NY;6. Department of Pediatrics, University of Washington School of Medicine (E Griego), Seattle, Wash;7. Department of Pediatrics, University of Utah School of Medicine, Primary Children''s Hospital (I Kocolas and F Cipriano), Salt Lake City, Utah |
| |
| Abstract: | ObjectivesTo examine differences in utilization across health care settings among children by body mass index (BMI) categories to help identify opportunities for interventions.MethodsA retrospective study was conducted using 1 year of electronic health records following an index primary care visit for children 3 to 17 years old in 2016. Index visits occurred at >40 pediatric practices affiliated with a Northeastern health system. Using normal BMI as a reference group, we examined the extent to which children's BMI percentile categories were associated with primary care visits, emergency department (ED) visits, hospitalizations, and ED visit acuity. Age, sex, race/ethnicity, and insurance status were used as covariates.ResultsOf those with biologically plausible values for height and weight (n = 30,352), the prevalences of overweight, obesity, and severe obesity were 16.3%, 12.4%, and 5.7%, respectively. Children outside of the normal BMI range made more primary care visits; however, relative patterns of ED utilization were not consistent. Children with obesity versus normal BMI were less likely to have ED visits of high acuity. Risk of hospitalization was higher among children with overweight or severe obesity.ConclusionsChildren's BMI categories were associated with health care utilization, specifically primary care visits, ED visits, and hospitalizations. Further investigation is needed to explore the drivers of these differences in utilization, such as the impact of stigma and perceived weight bias on care-seeking patterns, and to examine the role of settings outside of primary care in pediatric weight management. |
| |
| Keywords: | |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
