Frost Gary S, Lyons G Felicity
Department of Nutrition and Dietetics, Hammersmith Hospital, London, UK.
Obes Res. 2005 Aug;13(8):1442-9. doi: 10.1038/oby.2005.174.
To quantify the impact of obesity on the number of visits to both primary and secondary care teams.
The adult populations of 80 general practices throughout the United Kingdom were classified according to their BMI. We undertook a cross-sectional survey of computer-generated and handwritten records of 6150 obese people (BMI > or = 30 kg/m(2)) and 1150 normal weight (BMI = 18.5 to 24.9 kg/m(2)) control subjects over an 18-month retrospective period.
Obese patients made significantly more visits to the general practitioner (GP), practice nurse (PN), and hospital outpatient units than normal weight patients (all p < 0.001), and they were admitted to the hospital more often (p = 0.034). For both GP and PN visits, the relationship remained after adjusting for age, sex, social deprivation category, country, and number of comorbidities. Among obese patients, there was an increasing relationship between frequent GP visits (at least four appointments) and greater BMI, which remained significant after adjustment had been made for age, sex, deprivation, country, and number of comorbidities.
The human resource burden to general practice is significantly higher in the obese population than in the normal weight population, even when adjusted for confounding factors. The increase in prevalence of obesity will continue to put pressure on GP and PN time unless appropriate action is taken.
量化肥胖对基层医疗团队和二级医疗团队就诊次数的影响。
根据体重指数（BMI）对英国80家普通诊所的成年人口进行分类。我们对6150名肥胖者（BMI≥30kg/m²）和1150名体重正常者（BMI = 18.5至24.9kg/m²）的计算机生成记录和手写记录进行了为期18个月的回顾性横断面调查。
肥胖患者到全科医生（GP）、执业护士（PN）和医院门诊就诊的次数明显多于体重正常的患者（所有p<0.001），且他们住院的频率更高（p = 0.034）。对于全科医生和执业护士的就诊，在调整年龄、性别、社会剥夺类别、国家和合并症数量后，这种关系依然存在。在肥胖患者中，频繁就诊（至少4次预约）与更高的BMI之间存在递增关系，在调整年龄、性别、剥夺、国家和合并症数量后，这种关系依然显著。
即使在调整混杂因素后，肥胖人群给普通医疗带来的人力资源负担仍显著高于体重正常人群。肥胖患病率的上升将继续给全科医生和执业护士的时间带来压力，除非采取适当行动。
