Meyerovitch Joseph, Goldman Ran D, Avner-Cohen Herman, Antebi Felice, Sherf Michael
Institute for Endocrinology and Diabetes, National Center for Childhood Diabetes, Schneider Children's Medical Center of Israel, Petah Tikva, Israel.
Isr Med Assoc J. 2007 Nov;9(11):782-6.
The prevalence of obesity among children and adolescents in the western world has increased dramatically.
To assess the efficacy of routine childhood obesity screening by primary physicians in the pediatric population in Israel and the utilization of health services by overweight children.
The electronic medical records of children aged 60-83 months registered in 39 pediatric primary care centers between January 2001 and October 2004 (n=21,799) were reviewed. Those in whom height and weight were documented during a clinic visit (index visit) were classified as overweight, at risk of overweight, or normal weight according to body mass index percentiles. The number of visits to the pediatrician, laboratory tests and health care costs 12 months after the index visit were calculated.
Anthropomorphic measurements were performed in 1556 of the 15,364 children (10.1%) who visited the clinic during the study period. Of these, 398 (25.6%) were overweight, 185 (11.9%) were at risk of overweight, and 973 (62.5%) were normal weight. Children in the first two groups visited the clinic slightly more often than the third group, but the differences were not statistically significant (P = 0.12), and they had significantly more laboratory tests than the rest of the children visiting the clinics (P = 0.053). Health care costs were 6.6% higher for the overweight than the normal-weight children.
Electronic medical records are a useful tool for population-based health care assessments. Current screening for obesity in children during routine care in Israel is insufficient and additional education of community pediatricians in diagnosis and intervention is urgently needed.
西方世界儿童和青少年肥胖症的患病率急剧上升。
评估以色列儿科人群中初级医生进行常规儿童肥胖筛查的效果以及超重儿童对医疗服务的利用情况。
回顾了2001年1月至2004年10月期间在39个儿科初级保健中心登记的60 - 83个月大儿童的电子病历（n = 21,799）。在门诊就诊（索引就诊）期间记录了身高和体重的儿童，根据体重指数百分位数被分类为超重、有超重风险或体重正常。计算索引就诊后12个月内看儿科医生的次数、实验室检查次数和医疗费用。
在研究期间到诊所就诊的15,364名儿童中，有1556名（10.1%）进行了人体测量。其中，398名（25.6%）超重，185名（11.9%）有超重风险，973名（62.5%）体重正常。前两组儿童比第三组儿童看诊所的频率略高，但差异无统计学意义（P = 0.12），并且他们进行的实验室检查明显多于其他就诊儿童（P = 0.053）。超重儿童的医疗费用比体重正常的儿童高6.6%。
电子病历是基于人群的医疗保健评估的有用工具。以色列目前在常规护理期间对儿童肥胖症的筛查不足，迫切需要对社区儿科医生进行诊断和干预方面的额外培训。
